Surgical clip applier configured to store clips in a stored state

ABSTRACT

Surgical clip appliers are disclosed comprising a plurality of clips which are stored in a compressed state. When a stored clip is moved into the crimping chamber of the surgical clip applier, the clip can assume a configuration which is different than its stored configuration before it is crimped.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional application claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application Ser. No. 62/578,793,entitled SURGICAL INSTRUMENT WITH REMOTE RELEASE, filed Oct. 30, 2017,of U.S. Provisional Patent Application Ser. No. 62/578,804, entitledSURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENTTYPES OF END EFFECTOR MOVEMENT, filed Oct. 30, 2017, of U.S. ProvisionalPatent Application Ser. No. 62/578,817, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed Oct. 30, 2017, of U.S. Provisional Patent Application Ser. No.62/578,835, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed Oct. 30, 2017, of U.S.Provisional Patent Application Ser. No. 62/578,844, entitled SURGICALINSTRUMENT WITH MODULAR POWER SOURCES, filed Oct. 30, 2017, and of U.S.Provisional Patent Application Ser. No. 62/578,855, entitled SURGICALINSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed Oct. 30, 2017, thedisclosures of which are incorporated by reference herein in theirentirety. This non-provisional application claims the benefit under 35U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No.62/665,129, entitled SURGICAL SUTURING SYSTEMS, filed May 1, 2018, ofU.S. Provisional Patent Application Ser. No. 62/665,139, entitledSURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS, filed May 1, 2018, ofU.S. Provisional Patent Application Ser. No. 62/665,177, entitledSURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS, filed May 1, 2018,of U.S. Provisional Patent Application Ser. No. 62/665,128, entitledMODULAR SURGICAL INSTRUMENTS, filed May 1, 2018, of U.S. ProvisionalPatent Application Ser. No. 62/665,192, entitled SURGICAL DISSECTORS,filed May 1, 2018, and of U.S. Provisional Patent Application Ser. No.62/665,134, entitled SURGICAL CLIP APPLIER, filed May 1, 2018, thedisclosures of which are incorporated by reference herein in theirentirety.

BACKGROUND

A variety of fasteners can be utilized to treat, clamp, fasten, secure,and/or hold tissue. Clips can be positioned relative to tissue locatedwithin a surgical site in a patient and then deformed to apply aclamping force, for example, to the tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

The features and advantages of this invention, and the manner ofattaining them, will become more apparent and the invention itself willbe better understood by reference to the following description ofexemplary embodiments of the invention taken in conjunction with theaccompanying drawings, wherein:

FIG. 1 is a partial perspective view of a clip applier;

FIG. 2 is a cross-sectional view of an end effector of the clip applierof FIG. 1 comprising a removable clip cartridge, a reciprocating firingdrive for sequentially advancing the clips, a receiver for receiving theclips, and a crimping drive for deforming the clips;

FIG. 3 is a partial cross-sectional view of the clip applier of FIG. 1in an open configuration;

FIG. 4 is a partial cross-sectional view of the clip applier of FIG. 1in a closed configuration;

FIG. 5 is a cross-sectional view of the end effector of FIG. 2 in anunfired condition;

FIG. 6 is a cross-sectional view of the end effector of FIG. 2illustrating the firing drive in a partially fired condition in which afiring member of the firing drive has advanced a clip into the receiver;

FIG. 7 is a cross-sectional view of the end effector of FIG. 2illustrating the firing drive coming into engagement with the crimpingdrive;

FIG. 8 is a cross-sectional view of the end effector of FIG. 2illustrating the crimping drive in an at least partially firedcondition;

FIG. 9 is a cross-sectional view of the end effector of FIG. 2illustrating the firing drive becoming disengaged from the firingmember;

FIG. 10 is a cross-sectional view of the end effector of FIG. 2illustrating the crimping drive in its fully fired condition;

FIG. 11 is a cross-sectional view of the firing drive of the endeffector of FIG. 2 in a partially retracted position in which the firingdrive is being re-engaged with the firing member;

FIG. 12 is a cross-sectional view of the firing drive of the endeffector of FIG. 2 being disengaged from the crimping drive;

FIG. 13 is a perspective view of a clip illustrated in FIGS. 2-12;

FIG. 14 is a front view of a cartridge illustrated in FIGS. 1-12comprising a plurality of clips with portions of the cartridge removedto illustrate the clips stored in the cartridge;

FIG. 15 is a side view of the cartridge of FIG. 14 illustrated withportions removed to illustrate the clips stored in the cartridge;

FIG. 16 is a cross-sectional plan view of the cartridge of FIG. 14 takenalong line 16-16 in FIG. 15;

FIG. 17 is a side view of an alternative cartridge usable in connectionwith the clip applier of FIGS. 1-12 or any other suitable clip applier,wherein the cartridge is illustrated with portions removed to illustratea biasing member and a pusher plate positioned intermediate the biasingmember and the clips contained therein;

FIG. 18 is a side view of a cartridge in accordance with at least onealternative embodiment illustrated with portions removed to illustrate abiasing member and a lockout plate positioned intermediate the biasingmember and the clips contained therein;

FIG. 19 is a cross-sectional plan view of the cartridge of FIG. 18 takenalong line 19-19 in FIG. 18;

FIG. 20 is a side view of a further alternative cartridge usable inconnection with the clip applier of FIGS. 1-12 or any other suitableclip applier, wherein the cartridge can comprise a housing illustratedwith portions removed to illustrate a lockout plate comprising guideswhich are configured to co-operate with guides defined in the cartridgehousing;

FIG. 21 is a cross-sectional plan view of the cartridge of FIG. 20 takenalong line 21-21 in FIG. 20;

FIG. 22 is an elevational view of a firing drive comprising a rotaryinput, a rotary output, a firing nut engaged with the rotary output, anda transmission in a firing configuration in accordance with at least oneembodiment;

FIG. 23 is a perspective view of the firing drive of FIG. 22illustrating the firing nut in an unfired position;

FIG. 24 is a perspective view of the firing drive of FIG. 22illustrating the firing nut advanced along the rotary output and a camextending from the firing nut;

FIG. 25 is a perspective view of the firing drive of FIG. 22illustrating the cam of the firing nut engaged with the transmission ofthe firing drive and the transmission in a reverse configuration;

FIG. 26 is a perspective view of the firing drive of FIG. 22illustrating firing nut in a retracted position and a second camextending from the firing nut engaged with the transmission to shift thetransmission from its reverse configuration to its firing configuration;

FIG. 27 is a perspective view of a robotic surgical instrument systemoperably supporting a plurality of surgical tools usable with the clipapplier of FIGS. 2-12 or any other suitable clip applier;

FIG. 28 is a perspective view of a surgical tool including an actuatormodule, a shaft extending from the actuator module, and a replaceableend effector;

FIG. 29 is a perspective view of a handle actuator usable with the clipapplier of FIGS. 2-12 or any other suitable clip applier;

FIG. 30 is a cross-sectional view of the articulation joint illustratedin FIG. 2;

FIG. 31 is a rear perspective view of an alternative actuator modulethat may be used in place of the actuator module of FIG. 28 with atleast a portion of its housing removed;

FIG. 32 is an exploded view of a portion of the actuator module of FIG.31;

FIG. 33 is a partial sectional view of the actuator module of FIG. 31;

FIG. 34 is a cross-sectional view of an articulation actuator of theactuator module of FIG. 31;

FIG. 35A is a partial cross-sectional view of an end effector of a clipapplier in a closed configuration;

FIG. 35B is a partial cross-sectional view of the end effector of FIG.35A in an open configuration;

FIG. 35C is a cross-sectional view of the end effector of FIG. 35A in anopen configuration;

FIG. 36 is a partial cross-sectional view of the end effector of FIG.35A illustrating the position of a stored clip when a crimping drive ofthe end effector is in a fully fired position;

FIG. 37 is a partial cross-sectional view of the end effector of FIG.35A illustrating the position of the stored clip when the crimping driveis in a home position;

FIG. 38 is a partial cross-sectional view of the end effector of FIG.35A illustrating the position of the stored clip when the crimping driveis in a fully retracted position;

FIG. 39 is a partial cross-sectional view of a clip applier comprising aclip cartridge containing clips having a first size;

FIG. 40 is a partial cross-sectional view of the clip applier of FIG. 39comprising a different clip cartridge containing clips having a secondsize;

FIG. 41 is a partial cross-sectional view of a multi-level clip stackarrangement;

FIG. 42A is a perspective view of a clip applier comprising anattachment mechanism;

FIG. 42B is a cross-sectional view of the clip applier of FIG. 42A;

FIG. 43A is a perspective view of a clip applier comprising a clipmagazine;

FIG. 43B is a perspective view of clips for use with the clip applier ofFIG. 43A;

FIG. 44 is a perspective view of a clip reloader for use with a clipapplier comprising a clip magazine;

FIG. 45 is a perspective view of a clip reloader;

FIG. 46 is a cross-sectional view of the clip reloader of FIG. 45;

FIG. 47 is a cross-sectional view of the clip reloader of FIG. 45 and anend effector of a clip applier;

FIG. 48 is a partial cross-sectional plan view of a clip applier;

FIG. 49 is a partial cross-sectional side view of the clip applier ofFIG. 48;

FIG. 50 is a perspective view of the clip applier of FIG. 48;

FIG. 51A is a perspective view of a clip including a flexible base;

FIG. 51B is a side view of the clip of FIG. 51A in variousconfigurations;

FIG. 51C is a perspective view of a clip for use with a clip applier;

FIG. 51D is a side view of the clip of FIG. 51C in a storageconfiguration;

FIG. 51E is a side view of the clip of FIG. 51C in a pre-firingconfiguration;

FIG. 51F is a side view of the clip of FIG. 51C in a post-firingconfiguration;

FIG. 52 is a perspective view of a clip applier including a rotatableclip magazine;

FIG. 53 is a partial cross-sectional view of the clip applier of FIG. 52illustrating a closure tube of the clip applier in a fully retractedposition;

FIG. 54A is a partial cross-sectional view of the clip applier of FIG.52 illustrating the closure tube in a home position;

FIG. 54B is a perspective view of a ground portion including a clockingportion of the clip applier of FIG. 52;

FIG. 55 is a partial cross-sectional view of the clip applier of FIG. 52illustrating clips stored in the rotatable clip magazine prior to beingadvanced, illustrated with some components removed;

FIG. 56 is a partial cross-sectional view of the clip applier of FIG. 52illustrating a clip being advanced from the rotatable clip magazine by afeeder member of the clip applier;

FIG. 57 is a partial cross-sectional view of the clip applier of FIG. 52illustrating the feeder member retracted;

FIG. 58 is a partial cross-sectional view of the clip applier for FIG.52 illustrating a closure tube of the clip applier in a fully retractedposition;

FIG. 59 is a partial cross-sectional view of the clip applier of FIG. 52illustrating the closure tube in a home position and a firing memberadvancing a clip, illustrated with some components removed;

FIG. 60 is a partial cross-sectional view of the clip applier of FIG. 53illustrating the firing member retracted and the closure tube in a fullyadvanced position, illustrated with some components removed;

FIG. 61 is a partial cross-sectional view of a clip applier comprising areplaceable cartridge;

FIG. 62A is a cross-sectional end view of a rotatable clip magazine;

FIG. 62B is a plan view of a clip for use with the rotatable clipmagazine of FIG. 62A;

FIG. 63A is a perspective view of a releasable clip cartridge includingan articulation joint;

FIG. 63B is a partial cross-sectional view of the releasable clipcartridge and articulation joint of FIG. 63A;

FIG. 64 is a perspective view of a clip applier including anarticulation joint;

FIG. 65 is a partial cross-sectional view of a clip applier jawassembly;

FIG. 66A is a partial cross-sectional view of clip applier jaw assemblyincluding offset support legs;

FIG. 66B is a partial cross-sectional view of the clip applier jawassembly of FIG. 66A;

FIG. 67 is a partial cross sectional plan view of the clip applier jawassembly of FIG. 65;

FIG. 68 is a partial cross sectional plan view of the clip applier jawassembly of FIG. 66A;

FIG. 69 is a graphical depiction of the movements of a cam member and afeeder shoe of a clip applier throughout the operation of the clipapplier;

FIG. 70 is a graph depicting the displacement of a cam member and feedershoe of the clip applier of FIG. 52 as a function of time;

FIG. 71 depicts a first graph illustrating the force to advance a clipof a clip applier as a function of displacement and a second graphillustrating the voltage of a motor of the clip applier as a function oftime;

FIG. 72 depicts a graph of the force applied to a pair of jaws of a clipapplier versus time;

FIG. 73 is directed to an alternative embodiment;

FIG. 74 is directed to an alternative embodiment;

FIG. 75 is a perspective view of a clip applier including a rotatingclip magazine, a magnet, and a Hall Effect sensor;

FIG. 76 is a graphical depiction of the clip applier of FIG. 75illustrating the voltage of the Hall Effect sensor as a function of theposition of the magnet over time;

FIG. 77 is a partial cross-sectional view of a clip applier includingresistive sensing circuits;

FIG. 78A is a partial cross-sectional view of a clip applier including avariable resistance meter;

FIG. 78B is a partial cross-sectional view of the clip applier of FIG.78A in a partially crimped configuration;

FIG. 79 is a perspective view of a clip applier jaw including straingauges;

FIG. 80 is a graphical depiction of the clip applier jaw of FIG. 79illustrating the voltage of the strain gauges as a function of time;

FIG. 81A is a partial cross-sectional view of a clip applier including asensor array and a magnet;

FIG. 81B is a partial cross-sectional view of the clip applier of FIG.81A;

FIG. 82 is a perspective view of a clip applier system utilizing atrocar;

FIG. 83 is a perspective view of the clip applier system of FIG. 82;

FIG. 84A is a partial side elevation view of the clip applier system ofFIG. 82 depicting a jaw wing of a clip applier of the clip appliersystem positioned distal to a loading arm of a clip magazine of the clipapplier system;

FIG. 84B is a partial side elevation view of the clip applier system ofFIG. 82 depicting the jaw wing of the clip applier positioned proximalto the loading arm of the clip magazine;

FIG. 84C is a partial side elevation view of the clip applier system ofFIG. 82 depicting the jaw wing of the clip applier positioned proximalto the loading arm of the clip magazine;

FIG. 85A is a partial perspective view of the clip applier system ofFIG. 82;

FIG. 85B is a cross-sectional perspective view of the clip appliersystem of FIG. 82;

FIG. 86A is a plan view of the clip applier system of FIG. 82 depictinga jaw wing of the clip applier in an expanded configuration;

FIG. 86B is a plan view of the clip applier system of FIG. 82 depictingthe jaw wing of the clip applier in a retracted configuration;

FIG. 87A is a perspective view of a clip applier and a clip magazine foruse with the clip applier;

FIG. 87B is a perspective view of the clip magazine seated into the clipapplier of FIG. 87A;

FIG. 87C is a perspective view of the clip applier and the clip magazineof FIG. 87A in a loaded configuration;

FIG. 87D is a cross-sectional view of the clip applier and the clipmagazine of FIG. 87A in the loaded configuration of FIG. 87C;

FIG. 88A is a perspective view the spent clip magazine removed from theclip applier of FIG. 87A;

FIG. 88B is a plan view of the spent clip magazine seated into the clipapplier of FIG. 87A;

FIG. 88C is a cross-sectional plan view of the clip applier and the clipmagazine of FIG. 87A;

FIG. 88D is a cross-sectional plan view of the clip applier and the clipmagazine of FIG. 87A in a nearly spent configuration; and

FIG. 89 is a schematic of a control system for use with any of thesurgical instruments disclosed herein.

DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. PatentApplications that were filed on Aug. 24, 2018 and which are each hereinincorporated by reference in their respective entireties:

U.S. patent application Ser. No. 16/112,129, entitled SURGICAL SUTURINGINSTRUMENT CONFIGURED TO MANIPULATE TISSUE USING MECHANICAL ANDELECTRICAL POWER, now U.S. Patent Application Publication No.2019/0125431;

U.S. patent application Ser. No. 16/112,155, entitled SURGICAL SUTURINGINSTRUMENT COMPRISING A CAPTURE WIDTH WHICH IS LARGER THAN TROCARDIAMETER, now U.S. Patent Application Publication No. 2019/0125335;

U.S. patent application Ser. No. 16/112,168, entitled SURGICAL SUTURINGINSTRUMENT COMPRISING A NON-CIRCULAR NEEDLE, now U.S. Patent ApplicationPublication No. 2019/0125336;

U.S. patent application Ser. No. 16/112,180, entitled ELECTRICAL POWEROUTPUT CONTROL BASED ON MECHANICAL FORCES, now U.S. Patent ApplicationPublication No. 2019/0125432;

U.S. patent application Ser. No. 16/112,193, entitled REACTIVE ALGORITHMFOR SURGICAL SYSTEM, now U.S. Patent Application Publication No.2019/0125337;

U.S. patent application Ser. No. 16/112,099, entitled SURGICALINSTRUMENT COMPRISING AN ADAPTIVE ELECTRICAL SYSTEM, now U.S. PatentApplication Publication No. 2019/0125378;

U.S. patent application Ser. No. 16/112,112, entitled CONTROL SYSTEMARRANGEMENTS FOR A MODULAR SURGICAL INSTRUMENT, now U.S. PatentApplication Publication No. 2019/0125320;

U.S. patent application Ser. No. 16/112,119, entitled ADAPTIVE CONTROLPROGRAMS FOR A SURGICAL SYSTEM COMPRISING MORE THAN ONE TYPE OFCARTRIDGE, now U.S. Patent Application Publication No. 2019/0125338;

U.S. patent application Ser. No. 16/112,097, entitled SURGICALINSTRUMENT SYSTEMS COMPRISING BATTERY ARRANGEMENTS, now U.S. PatentApplication Publication No. 2019/0125377;

U.S. patent application Ser. No. 16/112,109, entitled SURGICALINSTRUMENT SYSTEMS COMPRISING HANDLE ARRANGEMENTS, now U.S. PatentApplication Publication No. 2019/0125388;

U.S. patent application Ser. No. 16/112,114, entitled SURGICALINSTRUMENT SYSTEMS COMPRISING FEEDBACK MECHANISMS, now U.S. PatentApplication Publication No. 2019/0142449;

U.S. patent application Ser. No. 16/112,117, entitled SURGICALINSTRUMENT SYSTEMS COMPRISING LOCKOUT MECHANISMS, now U.S. PatentApplication Publication No. 2019/0125476;

U.S. patent application Ser. No. 16/112,095, entitled SURGICALINSTRUMENTS COMPRISING A LOCKABLE END EFFECTOR SOCKET;

U.S. patent application Ser. No. 16/112,121, entitled SURGICALINSTRUMENTS COMPRISING A SHIFTING MECHANISM, now U.S. Patent ApplicationPublication No. 2019/0125387;

U.S. patent application Ser. No. 16/112,151, entitled SURGICALINSTRUMENTS COMPRISING A SYSTEM FOR ARTICULATION AND ROTATIONCOMPENSATION, now U.S. Pat. No. 10,772,651;

U.S. patent application Ser. No. 16/112,154, entitled SURGICALINSTRUMENTS COMPRISING A BIASED SHIFTING MECHANISM, now U.S. PatentApplication Publication No. 2019/0125321;

U.S. patent application Ser. No. 16/112,226, entitled SURGICALINSTRUMENTS COMPRISING AN ARTICULATION DRIVE THAT PROVIDES FOR HIGHARTICULATION ANGLES, now U.S. Patent Application Publication No.2019/0125379;

U.S. patent application Ser. No. 16/112,062, entitled SURGICALDISSECTORS AND MANUFACTURING TECHNIQUES, now U.S. Patent ApplicationPublication No. 2019/0125386;

U.S. patent application Ser. No. 16/112,098, entitled SURGICALDISSECTORS CONFIGURED TO APPLY MECHANICAL AND ELECTRICAL ENERGY, nowU.S. Patent Application Publication No. 2019/0125430;

U.S. patent application Ser. No. 16/112,245, entitled SURGICAL CLIPAPPLIER COMPRISING AN EMPTY CLIP CARTRIDGE LOCKOUT, now U.S. PatentApplication Publication No. 2019/0125352;

U.S. patent application Ser. No. 16/112,249, entitled SURGICAL CLIPAPPLIER COMPRISING AN AUTOMATIC CLIP FEEDING SYSTEM, now U.S. PatentApplication Publication No. 2019/0125353;

U.S. patent application Ser. No. 16/112,253, entitled SURGICAL CLIPAPPLIER COMPRISING ADAPTIVE FIRING CONTROL, now U.S. Patent ApplicationPublication No. 2019/0125348; and

U.S. patent application Ser. No. 16/112,257, entitled SURGICAL CLIPAPPLIER COMPRISING ADAPTIVE CONTROL IN RESPONSE TO A STRAIN GAUGECIRCUIT, now U.S. Patent Application Publication No. 2019/0125354.

Applicant of the present application owns the following U.S. PatentApplications that were filed on May 1, 2018 and which are each hereinincorporated by reference in their respective entireties:

U.S. Provisional Patent Application Ser. No. 62/665,129, entitledSURGICAL SUTURING SYSTEMS;

U.S. Provisional Patent Application Ser. No. 62/665,139, entitledSURGICAL INSTRUMENTS COMPRISING CONTROL SYSTEMS;

U.S. Provisional Patent Application Ser. No. 62/665,177, entitledSURGICAL INSTRUMENTS COMPRISING HANDLE ARRANGEMENTS;

U.S. Provisional Patent Application Ser. No. 62/665,128, entitledMODULAR SURGICAL INSTRUMENTS;

U.S. Provisional Patent Application Ser. No. 62/665,192, entitledSURGICAL DISSECTORS; and

U.S. Provisional Patent Application Ser. No. 62/665,134, entitledSURGICAL CLIP APPLIER.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Feb. 28, 2018 and which are each hereinincorporated by reference in their respective entireties:

U.S. patent application Ser. No. 15/908,021, entitled SURGICALINSTRUMENT WITH REMOTE RELEASE;

U.S. patent application Ser. No. 15/908,012, entitled SURGICALINSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OFEND EFFECTOR MOVEMENT;

U.S. patent application Ser. No. 15/908,040, entitled SURGICALINSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTORFUNCTIONS;

U.S. patent application Ser. No. 15/908,057, entitled SURGICALINSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTORFUNCTIONS;

U.S. patent application Ser. No. 15/908,058, entitled SURGICALINSTRUMENT WITH MODULAR POWER SOURCES; and

U.S. patent application Ser. No. 15/908,143, entitled SURGICALINSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.

Applicant of the present application owns the following U.S. PatentApplications that were filed on Oct. 30, 2017 and which are each hereinincorporated by reference in their respective entireties:

U.S. Provisional Patent Application Ser. No. 62/578,793, entitledSURGICAL INSTRUMENT WITH REMOTE RELEASE;

U.S. Provisional Patent Application Ser. No. 62/578,804, entitledSURGICAL INSTRUMENT HAVING DUAL ROTATABLE MEMBERS TO EFFECT DIFFERENTTYPES OF END EFFECTOR MOVEMENT;

U.S. Provisional Patent Application Ser. No. 62/578,817, entitledSURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE ENDEFFECTOR FUNCTIONS;

U.S. Provisional Patent Application Ser. No. 62/578,835, entitledSURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE ENDEFFECTOR FUNCTIONS;

U.S. Provisional Patent Application Ser. No. 62/578,844, entitledSURGICAL INSTRUMENT WITH MODULAR POWER SOURCES; and

U.S. Provisional Patent Application Ser. No. 62/578,855, entitledSURGICAL INSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications, filed on Dec. 28, 2017, the disclosure of each ofwhich is herein incorporated by reference in its entirety:

U.S. Provisional Patent Application Ser. No. 62/611,341, entitledINTERACTIVE SURGICAL PLATFORM;

U.S. Provisional Patent Application Ser. No. 62/611,340, entitledCLOUD-BASED MEDICAL ANALYTICS; and

U.S. Provisional Patent Application Ser. No. 62/611,339, entitled ROBOTASSISTED SURGICAL PLATFORM.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications, filed on Mar. 28, 2018, each of which is hereinincorporated by reference in its entirety:

U.S. Provisional Patent Application Ser. No. 62/649,302, entitledINTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;

U.S. Provisional Patent Application Ser. No. 62/649,294, entitled DATASTRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZEDRECORD;

U.S. Provisional Patent Application Ser. No. 62/649,300, entitledSURGICAL HUB SITUATIONAL AWARENESS;

U.S. Provisional Patent Application Ser. No. 62/649,309, entitledSURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATINGTHEATER;

U.S. Provisional Patent Application Ser. No. 62/649,310, entitledCOMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;

U.S. Provisional Patent Application Ser. No. 62/649,291, entitled USE OFLASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OFBACK SCATTERED LIGHT;

U.S. Provisional Patent Application Ser. No. 62/649,296, entitledADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;

U.S. Provisional Patent Application Ser. No. 62/649,333, entitledCLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO AUSER;

U.S. Provisional Patent Application Ser. No. 62/649,327, entitledCLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS ANDREACTIVE MEASURES;

U.S. Provisional Patent Application Ser. No. 62/649,315, entitled DATAHANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;

U.S. Provisional Patent Application Ser. No. 62/649,313, entitled CLOUDINTERFACE FOR COUPLED SURGICAL DEVICES;

U.S. Provisional Patent Application Ser. No. 62/649,320, entitled DRIVEARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. Provisional Patent Application Ser. No. 62/649,307, entitledAUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and

U.S. Provisional Patent Application Ser. No. 62/649,323, entitledSENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. PatentApplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

U.S. patent application Ser. No. 15/940,641, entitled INTERACTIVESURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;

U.S. patent application Ser. No. 15/940,648, entitled INTERACTIVESURGICAL SYSTEMS WITH CONDITION HANDLING OF DEVICES AND DATACAPABILITIES;

U.S. patent application Ser. No. 15/940,656, entitled SURGICAL HUBCOORDINATION OF CONTROL AND COMMUNICATION OF OPERATING ROOM DEVICES;

U.S. patent application Ser. No. 15/940,666, entitled SPATIAL AWARENESSOF SURGICAL HUBS IN OPERATING ROOMS;

U.S. patent application Ser. No. 15/940,670, entitled COOPERATIVEUTILIZATION OF DATA DERIVED FROM SECONDARY SOURCES BY INTELLIGENTSURGICAL HUBS;

U.S. patent application Ser. No. 15/940,677, entitled SURGICAL HUBCONTROL ARRANGEMENTS;

U.S. patent application Ser. No. 15/940,632, entitled DATA STRIPPINGMETHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;

U.S. patent application Ser. No. 15/940,640, entitled COMMUNICATION HUBAND STORAGE DEVICE FOR STORING PARAMETERS AND STATUS OF A SURGICALDEVICE TO BE SHARED WITH CLOUD BASED ANALYTICS SYSTEMS;

U.S. patent application Ser. No. 15/940,645, entitled SELF DESCRIBINGDATA PACKETS GENERATED AT AN ISSUING INSTRUMENT;

U.S. patent application Ser. No. 15/940,649, entitled DATA PAIRING TOINTERCONNECT A DEVICE MEASURED PARAMETER WITH AN OUTCOME;

U.S. patent application Ser. No. 15/940,654, entitled SURGICAL HUBSITUATIONAL AWARENESS;

U.S. patent application Ser. No. 15/940,663, entitled SURGICAL SYSTEMDISTRIBUTED PROCESSING;

U.S. patent application Ser. No. 15/940,668, entitled AGGREGATION ANDREPORTING OF SURGICAL HUB DATA;

U.S. patent application Ser. No. 15/940,671, entitled SURGICAL HUBSPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;

U.S. patent application Ser. No. 15/940,686, entitled DISPLAY OFALIGNMENT OF STAPLE CARTRIDGE TO PRIOR LINEAR STAPLE LINE;

U.S. patent application Ser. No. 15/940,700, entitled STERILE FIELDINTERACTIVE CONTROL DISPLAYS;

U.S. patent application Ser. No. 15/940,629, entitled COMPUTERIMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;

U.S. patent application Ser. No. 15/940,704, entitled USE OF LASER LIGHTAND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTEREDLIGHT;

U.S. patent application Ser. No. 15/940,722, entitled CHARACTERIZATIONOF TISSUE IRREGULARITIES THROUGH THE USE OF MONO-CHROMATIC LIGHTREFRACTIVITY; and

U.S. patent application Ser. No. 15/940,742, entitled DUAL CMOS ARRAYIMAGING.

Applicant of the present application owns the following U.S. PatentApplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

U.S. patent application Ser. No. 15/940,636, entitled ADAPTIVE CONTROLPROGRAM UPDATES FOR SURGICAL DEVICES;

U.S. patent application Ser. No. 15/940,653, entitled ADAPTIVE CONTROLPROGRAM UPDATES FOR SURGICAL HUBS;

U.S. patent application Ser. No. 15/940,660, entitled CLOUD-BASEDMEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;

U.S. patent application Ser. No. 15/940,679, entitled CLOUD-BASEDMEDICAL ANALYTICS FOR LINKING OF LOCAL USAGE TRENDS WITH THE RESOURCEACQUISITION BEHAVIORS OF LARGER DATA SET;

U.S. patent application Ser. No. 15/940,694, entitled CLOUD-BASEDMEDICAL ANALYTICS FOR MEDICAL FACILITY SEGMENTED INDIVIDUALIZATION OFINSTRUMENT FUNCTION;

U.S. patent application Ser. No. 15/940,634, entitled CLOUD-BASEDMEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVEMEASURES;

U.S. patent application Ser. No. 15/940,706, entitled DATA HANDLING ANDPRIORITIZATION IN A CLOUD ANALYTICS NETWORK; and

U.S. patent application Ser. No. 15/940,675, entitled CLOUD INTERFACEFOR COUPLED SURGICAL DEVICES.

Applicant of the present application owns the following U.S. PatentApplications, filed on Mar. 29, 2018, each of which is hereinincorporated by reference in its entirety:

U.S. patent application Ser. No. 15/940,627, entitled DRIVE ARRANGEMENTSFOR ROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. patent application Ser. No. 15/940,637, entitled COMMUNICATIONARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. patent application Ser. No. 15/940,642, entitled CONTROLS FORROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. patent application Ser. No. 15/940,676, entitled AUTOMATIC TOOLADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. patent application Ser. No. 15/940,680, entitled CONTROLLERS FORROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. patent application Ser. No. 15/940,683, entitled COOPERATIVESURGICAL ACTIONS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;

U.S. patent application Ser. No. 15/940,690, entitled DISPLAYARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and

U.S. patent application Ser. No. 15/940,711, entitled SENSINGARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.

Applicant of the present application owns the following U.S. ProvisionalPatent Applications, filed on Mar. 30, 2018, each of which is hereinincorporated by reference in its entirety:

U.S. Provisional Patent Application Ser. No. 62/650,887, entitledSURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES;

U.S. Provisional Patent Application Ser. No. 62/650,877, entitledSURGICAL SMOKE EVACUATION SENSING AND CONTROLS;

U.S. Provisional Patent Application Ser. No. 62/650,882, entitled SMOKEEVACUATION MODULE FOR INTERACTIVE SURGICAL PLATFORM; and

U.S. Provisional Patent Application Ser. No. 62/650,898, entitledCAPACITIVE COUPLED RETURN PATH PAD WITH SEPARABLE ARRAY ELEMENTS.

Applicant of the present application owns the following U.S. ProvisionalPatent Application, filed on Apr. 19, 2018, which is herein incorporatedby reference in its entirety:

U.S. Provisional Patent Application Ser. No. 62/659,900, entitled METHODOF HUB COMMUNICATION.

Numerous specific details are set forth to provide a thoroughunderstanding of the overall structure, function, manufacture, and useof the embodiments as described in the specification and illustrated inthe accompanying drawings. Well-known operations, components, andelements have not been described in detail so as not to obscure theembodiments described in the specification. The reader will understandthat the embodiments described and illustrated herein are non-limitingexamples, and thus it can be appreciated that the specific structuraland functional details disclosed herein may be representative andillustrative. Variations and changes thereto may be made withoutdeparting from the scope of the claims.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”), and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, a surgicalsystem, device, or apparatus that “comprises,” “has,” “includes”, or“contains” one or more elements possesses those one or more elements,but is not limited to possessing only those one or more elements.Likewise, an element of a system, device, or apparatus that “comprises,”“has,” “includes”, or “contains” one or more features possesses thoseone or more features, but is not limited to possessing only those one ormore features.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” refers to the portion closest to the clinician andthe term “distal” refers to the portion located away from the clinician.It will be further appreciated that, for convenience and clarity,spatial terms such as “vertical”, “horizontal”, “up”, and “down” may beused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, thereader will readily appreciate that the various methods and devicesdisclosed herein can be used in numerous surgical procedures andapplications including, for example, in connection with open surgicalprocedures. As the present Detailed Description proceeds, the readerwill further appreciate that the various instruments disclosed hereincan be inserted into a body in any way, such as through a naturalorifice, through an incision or puncture hole formed in tissue, etc. Theworking portions or end effector portions of the instruments can beinserted directly into a patient's body or can be inserted through anaccess device that has a working channel through which the end effectorand elongate shaft of a surgical instrument can be advanced.

During various surgical procedures, a surgeon, or other clinician, mayapply a clip to a patient's tissue in order to achieve various effectsand/or therapeutic results. Referring to FIG. 1, a surgical instrument,such as a clip applier 100, for example, can be configured to apply oneor more clips to tissue located within a surgical site in the patient.Generally, referring now to FIG. 13, the clip applier 100 can bestructured and arranged to position a clip 140 relative to the tissue inorder to compress the tissue within the clip 140. The clip applier 100can be configured to deform the clip 140 as illustrated in FIGS. 3 and4, for example, and as described in greater detail further below. Eachclip 140 can comprise a base 142 and opposing legs 144 extending fromthe base 142. The base 142 and the legs 144 can comprise any suitableshape and can define a substantially U-shaped configuration and/or asubstantially V-shaped configuration, for example. The base 142 cancomprise angled portions 141 which are connected together by a joint143. In use, the legs 144 of the clip 140 can be positioned on oppositesides of the tissue wherein the legs 144 can be pushed toward oneanother to compress the tissue positioned between the legs 144. Thejoint 143 can be configured to permit the angled portions 141 of thebase 142, and the legs 144 extending therefrom, to deform inwardly. Invarious circumstances, the clip 140 can be configured to yield, ordeform plastically, when the clip 140 is sufficiently compressed,although some amount of elastic deformation, or spring-back, may occurwithin the deformed clip 140.

Referring now to FIGS. 1 and 2, the clip applier 100 can include a shaft110, an end effector 120, and a replaceable clip cartridge, or magazine,130. Referring to FIGS. 14-16, the clip cartridge 130 can comprise ahousing 132 and a plurality of clips 140 positioned within the housing132. The housing 132 can define a storage chamber 134 in which the clips140 can be stacked. The storage chamber 134 can comprise sidewalls whichextend around, or at least substantially around, the perimeter of theclips 140. Referring again to FIG. 13, each clip 140 can compriseopposing faces, such as a top face 145 and a bottom face 146 on oppositesides of the clip 140 wherein, when the clips 140 are stacked in thehousing 132, the top face 145 of a clip 140 can be positioned againstthe bottom face 146 of an adjacent clip 140 and wherein the bottom face146 of the clip 140 can be positioned against the top face 145 ofanother adjacent clip 140. In various circumstances, the bottom faces146 of the clips 140 can face downwardly toward one or more supportshelves, or platforms, 135 defined in the housing 132 while the topfaces 145 of the clips 140 can face upwardly away from the supportshelves 135. The top faces 145 and the bottom faces 146 of the clips 140may be identical, or at least substantially identical, in some cases,while, in other cases, the top faces 145 and the bottom faces 146 may bedifferent. The stack of clips 140 depicted in FIGS. 14-16 comprises fiveclips 140, for example; however, other embodiments are envisioned inwhich the stack of clips 140 can include more than five clips 140 orless than five clips 140. In any event, the clip cartridge 130 canfurther comprise at least one biasing member, such as biasing member136, for example, positioned intermediate the housing 132 and the topclip 140 in the stack of clips 140. As described in greater detailbelow, the biasing member 136 can be configured to bias the bottom clip140 in the stack of clips 140 or, more particularly, the bottom face 146of the bottom clip 140, against the support shelves 135 defined in thehousing 132. The biasing member 136 can comprise a spring, and/or anysuitable compressed elastic element, for example, which can beconfigured to apply a biasing force to the clips 140, or at least applya biasing force to the top clip 140 which is transmitted downwardlythrough the stack of clips 140.

When a clip 140 is positioned against the support shelves 135 asdescribed above, the clip 140 can be supported in a firing position inwhich the clip 140 can be advanced and ejected from the cartridge 130.In various circumstances, the support shelves 135 can define at least aportion of a firing chamber 149 in which the clips 140 can besequentially positioned in the firing position. In some cases, thefiring chamber 149 can be entirely defined within the cartridge 130 or,in other cases, the firing chamber 149 can be defined within and/orbetween the shaft 110 and the cartridge 130. In any event, as describedin greater detail further below, the clip applier 100 can comprise afiring drive which can advance a firing member into the cartridge 130and push the clip 140 from its firing position positioned against thesupport shelves 135 to a fired position in which it is received withinthe end effector 120 of the clip applier 100. Referring primarily toFIGS. 14-16, the housing 132 of the cartridge 130 can comprise aproximal opening, or window, 133 which can be aligned, or at leastsubstantially aligned, with the support shelves 135 such that the firingmember can enter into the cartridge 130 through the proximal opening 133and advance a clip 140 distally out of the cartridge 130. In at leastone such embodiment, the housing 132 can further comprise a distal, ordischarge, opening, or window, 137 which is also aligned with thesupport shelves 135 such that the clip 140 can be advanced, or fired,distally along a firing axis 139 extending through the proximal opening133, the firing chamber 149, and the distal opening 137, for example.

In order to advance a clip 140 out of the cartridge 130, further to theabove, the firing member of the firing drive can be advanced into to thecartridge housing 132 and, in various circumstances, into the firingchamber 149. As disclosed in greater detail further below, the firingmember can pass entirely through the cartridge 130 in order to advancethe clip 140 into its fired position within the end effector 120. Afterthe clip 140 positioned in the firing chamber 149 has been advanceddistally by the firing member, as outlined above, the firing member canbe retracted sufficiently such that the biasing member 136 can positionanother clip 140 against the support shelves 135. In variouscircumstances, the biasing member 136 can bias a clip 140 against thefiring member while the firing member is positioned within the housing132. Such a clip 140 can be referred to as a queued clip. After thefiring member has been sufficiently retracted and slid out fromunderneath the queued clip 140, the biasing member 136 can then bias theclip 140 against the support shelves 135 where it is staged for the nextstroke of the reciprocating firing member. Referring primarily to FIGS.2 and 14-16, the cartridge 130 can be configured to supply the clips 140to the firing chamber 149 along a predetermined path, such as supplyaxis 138, for example. The supply axis 138 can be transverse to thefiring axis 139 such that the clips 140 are fed into the firing chamber149 in a direction which is different than the direction in which thefiring member passes through the firing chamber 149. In at least onesuch embodiment, the supply axis 138 can be perpendicular, or at leastsubstantially perpendicular, to the firing axis 139, for example.

Referring again to FIG. 2, the shaft 110 can comprise a cartridge, ormagazine, aperture 131 which can be sized and configured to receive aclip cartridge 130, for example, therein. The cartridge aperture 131 canbe sized and configured such that the housing 132 of the cartridge 130is closely received within the cartridge aperture 131. The sidewallswhich define the cartridge aperture 131 can limit, or at leastsubstantially limit, the lateral movement of the cartridge 130 relativeto the shaft 110. The shaft 110 and/or the cartridge 130 can furthercomprise one or more locks which can be configured to releasably holdthe cartridge 130 in the cartridge aperture 131. As illustrated in FIG.2, the cartridge 130 can be loaded into the cartridge aperture 131 alongan axis which is, in at least one embodiment, parallel to or collinearwith the supply axis 138. As also illustrated in FIG. 2, the shaft 110can further comprise a pad or seat 118 extending from the sidewall 111of the shaft 110 wherein the pad 118 can be configured to be receivedwithin and/or engaged with the housing 132 of the cartridge 130. The pad118 can be sized and configured to be closely received within a recess148 defined in the cartridge housing such that the pad 118 can limit, orat least substantially limit, the lateral movement of the cartridge 130relative to the shaft 110. The pad 118 can be sized and configured toalign the cartridge 130 within the shaft 110 and/or support thecartridge housing 132.

Once the clip cartridge 130 has been positioned and seated within theshaft aperture 131, referring now to FIGS. 5 and 6, a firing drive 160of the clip applier 100 can be actuated to advance the clips 140 fromthe clip cartridge 130 as described above. The firing drive 160 cancomprise a rotary drive input such as a drive screw 161, for example,and a displaceable firing nut 163 operably engaged with the drive screw161. The drive screw 161 can comprise at least one drive thread 162which can be threadably engaged with a threaded aperture extendingthrough the firing nut 163. In various embodiments, the clip applier 100can further include an electric motor, for example, operably coupledwith the drive screw 161. In various instances, the drive screw 161 canbe operably coupled with the motor of a surgical instrument systemcomprising a hand-held instrument or a robotic arm, for example. In anyevent, the movement of the firing nut 163 within the shaft 110 can beconstrained such that the firing nut 163 moves along a longitudinal axis164 when the drive screw 161 is rotated about the longitudinal axis 164by the motor. For instance, when the drive screw 161 is rotated in afirst direction by the motor, the drive screw 161 can advance the firingnut 163 distally toward the end effector 120, as illustrated in FIG. 6.When the drive screw 161 is rotated in a direction opposite the firstdirection by the motor, the drive screw 161 can retract the firing nut163 proximally away from the end effector 120. The shaft 110 cancomprise one or more bearings which can be configured to rotatablysupport the drive screw 161. For instance, a bearing 159 can beconfigured to rotatably support the distal end of the drive screw 161,for example, as illustrated in FIGS. 5 and 6.

The firing drive 160 can further comprise a firing member 165 extendingfrom the firing nut 163 which can be advanced distally and retractedproximally with the firing nut 163, as described in greater detailfurther below. Upon comparing FIGS. 5 and 6, the reader will note thatthe firing nut 163 and the firing member 165 have been advanced from aproximal, unfired position, illustrated in FIG. 5, to a distal, firedposition, illustrated in FIG. 6, in which the firing member 165 hasadvanced a clip 140 from the clip cartridge 130 into the end effector120. Referring primarily to FIG. 5, the clip cartridge 130 isillustrated as comprising a plurality of clips 140 stored thereinwherein one of the clips 140 is positioned in a firing position, asdescribed above. As illustrated in FIGS. 5 and 6, the firing member 165can include a distal portion 166 which can be advanced into the staplecartridge 130 along a firing axis 167 and engage the clip 140 positionedin the firing position when the firing member 165 and the firing nut 163are advanced distally. In some cases, the firing member 165 can comprisea linear member while, in other cases, the distal end 166 of the firingmember 165 can extend upwardly from the firing member 165, for example.Further to the above, the firing member 165 can advance the clip 140distally out of the clip cartridge 130 along the firing axis 167 andinto a receiving cavity 122 defined in the end effector 120.

In various cases, the firing member 165 can be attached to and extenddistally from the firing nut 163 while, in other cases, the firingmember 165 and the firing nut 163 can be operably connected to oneanother by a firing actuator 168. The firing actuator 168 can bepivotably mounted to the firing member 165 at a pivot 169 and caninclude a distal arm 170 a and a proximal arm 170 b which can be engagedwith a longitudinal slot 113 defined in the housing 112 of the shaft110. In at least one such embodiment, each of the arms 170 a, 170 b caninclude a projection, such as projections 171 a and 171 b, respectively,extending therefrom which can be configured to slide within thelongitudinal slot 113. Further to the above, the firing nut 163 canfurther include a firing pin 172 extending therefrom which can beconfigured to engage the distal arm 170 a in order to advance theactuator 168 and the firing member 165 distally, as described above. Inuse, referring again to the progression illustrated in FIGS. 5 and 6,the firing nut 163 can be advanced distally by the drive screw 161wherein the firing pin 172, which is positioned intermediate the distalarm 170 a and the proximal arm 170 b, can contact the distal arm 170 aand drive the actuator 168 and the firing member 165 distally. As theactuator 168 is advanced distally, the actuator 168 may be preventedfrom rotating about the pivot pin 169 as one or both of the projections171 a and 171 b sliding in the shaft slot 113 can be prevented frombeing moved laterally relative to the longitudinal shaft slot 113 untilthe actuator 168 reaches the position illustrated in FIG. 6.

When the actuator 168 has reached the position illustrated in FIG. 6,the distal projection 171 a can enter into a distal slot portion 114 ofthe longitudinal slot 113 which can be configured to pivot the actuator168 downwardly, or permit the actuator 168 to be pivoted downwardly, asillustrated in FIG. 9. In at least one such embodiment, the distalprojection 171 a can come into contact with the sidewall of the distalslot portion 114 which can guide the distal projection 171 a downwardlyand pivot the actuator 168 about the pivot 169 as the actuator 168 isadvanced forward by the firing nut 163. In such a pivoted position, thefiring pin 172 extending from the firing nut 163 may no longer beengaged with the distal arm 170 a of the actuator 168 wherein,subsequently, the firing nut 163 may move distally independently of theactuator 168 thereby leaving behind the actuator 168 and the firingmember 165. Stated another way, the distal end 114 of the longitudinalshaft slot 113 may deactivate the firing member 165 wherein, at suchpoint, the position of the firing member 165 may represent thefully-fired or distal-most position of the firing member 165. In such aposition, the clip 140 has been fully advanced into the receivingcavity, or receiver, 122. Furthermore, in such a position, the next clip140 to be advanced into the receiving cavity 122 may be biased againstthe top surface of the firing member 165, further to the above.

Once a clip 140 has been positioned within the receiving cavity 122,further to the above, the clip 140 can be deformed by a crimping drive180, for example. Referring now to FIGS. 3 and 4, the end effector 120of the clip applier 100 can further comprise a first jaw 123 a and asecond jaw 123 b wherein the first jaw 123 a and the second jaw 123 bcan at least partially define the receiving chamber 122. As illustratedin FIGS. 3 and 4, the first jaw 123 a can comprise a first channel 124 aand the second jaw 123 b can comprise a second channel 124 b which caneach be configured to receive and support at least a portion of a clip140 therein. The first jaw 123 a can be pivotably coupled to a frame 111of the shaft 110 by a pin 125 a and the second jaw 123 b can bepivotably coupled to the frame 111 by a pin 125 b. In use, the crimpingdrive 180 can be configured to rotate the first jaw 123 a toward thesecond jaw 123 b and/or rotate the second jaw 123 b toward the first jaw123 a in order to compress the clip 140 positioned therebetween. In atleast one such embodiment, the crimping drive 180 can comprise a camactuator 181 which can be configured to engage a first cam surface 126 adefined on the first jaw 123 a and a second cam surface 126 b on thesecond jaw 123 b in order to pivot the first jaw 123 a and the secondjaw 123 b toward one another. The cam actuator 181 can comprise a collarwhich at least partially surrounds the first jaw 123 a and the secondjaw 123 b. In at least one such embodiment, the collar can comprise aninner cam surface 182 which can be contoured to contact the cam surfaces126 a, 126 b of the jaws 123 a, 123 b and drive them inwardly toward oneanother. In various circumstances, the clip 140 positioned within thereceiving chamber 122 defined in the end effector 120 can be positionedrelative to tissue before the crimping drive 180 is actuated. In somecircumstances, the crimping drive 180 can be at least partially actuatedprior to positioning the clip 140 relative to the tissue in order to atleast partially compress the clip 140. In certain instances, the clip140 and the receiving chamber 122 can be sized and configured such thatthe clip 140 can be biased or flexed inwardly when the end effector 120is in its unactuated state, as illustrated in FIG. 3. In variousinstances, the crimping first jaw 123 a and the second jaw 123 b can beactuated to elastically crimp and/or permanently crimp the clip 140positioned therebetween.

Further to the above, the firing nut 163 can be configured to actuatethe crimping drive 180. More particularly, referring now to FIG. 7, thecrimping drive 180 can comprise a crimping actuator 188 operably coupledwith the cam actuator 181 wherein the crimping actuator 188 can beselectively engaged by the firing nut 163 as the firing nut 163 isadvanced distally as described above. In at least one such embodiment,the firing nut 163 can further comprise a second firing pin, such asfiring pin 184, for example, extending therefrom which can be configuredto engage the crimping actuator 188 as the firing nut 163 is advancingthe firing actuator 168. Referring again to FIG. 7, the crimpingactuator 188 is positioned in an unactuated position and, when thefiring nut 163 is advanced sufficiently to engage a distal arm 190 a ofthe crimping actuator 188, the firing nut 163 can rotate the crimpingactuator 188 upwardly into an actuated position as illustrated in FIG.8. As also illustrated in FIG. 8, the distal arm 190 a and a proximalarm 190 b can each comprise a projection, such as projections 191 a and191 b, respectively, extending therefrom which can be positioned withina second longitudinal slot defined in shaft 110, such as slot 115, forexample. As the crimping actuator 188 is rotated upwardly from itsunactuated position about a pivot 189, the projections 191 a and 191 bcan move from the proximal curved end 116 of the longitudinal slot 115into a portion of the longitudinal slot 115 which is substantiallylinear. Similar to the above, the sidewalls of the longitudinal slot 115can be configured to confine the movement of the crimping actuator 188along a longitudinal path and can be configured to limit or prevent therotation of the crimping actuator 188 once the crimping actuator 188 hasbeen rotated upwardly into an at least partially actuated position, asdiscussed above. As the reader will understand, the firing pin 172 ofthe firing drive 160 and the firing pin 184 of the crimping drive 180both extend from the firing nut 163. For the sake of expediency anddemonstration, the firing pins 172 and 184 are illustrated as extendingfrom the same side of the firing nut 163; however, it is envisioned thatthe firing pin 172 can extend from a first lateral side of the firingnut 163 while the firing pin 184 can extend from the other lateral sideof the firing nut 163. In such circumstances, the firing actuator 168can be positioned alongside the first lateral side of the drive screw161 and the crimping actuator 188 can be positioned alongside theopposite lateral side of the drive screw 161. Correspondingly, thelongitudinal slot 113 can be defined in a first lateral side of theshaft housing 112 while the longitudinal slot 115 can be defined in theopposite lateral side of the shaft housing 112.

Further to the above, the cam actuator 181 can be operably coupled withcrimping actuator 188 such that, when the crimping actuator 188 isadvanced distally by the firing nut 163, the cam actuator 181 can beadvanced distally, as illustrated in FIGS. 8 and 10, until the distalprojection 191 a extending from the distal arm 190 a reaches the distalend 117 of the longitudinal slot 115. In such a distal position, the camactuator 181 may be in a fully advanced position and the clip 140positioned within the receiving chamber 122 can be in a fully deformedor crimped configuration. Thereafter, the cam actuator 181 can beretracted and the end effector 120 can be reopened. More particularly,the drive screw 161 can be rotated in an opposite direction in order tomove the firing nut 163 proximally and retract the cam actuator 181wherein, in certain instances, the end effector 120 can further includea biasing member which can be configured to bias the first jaw 123 andthe second jaw 123 b from the closed, or fired, position illustrated inFIG. 4 into the open, or unfired, position illustrated in FIG. 3. As thefiring nut 163 is retracted from its position illustrated in FIG. 10,the firing pin 184 extending from the firing nut 163 can engage theproximal arm 190 b of the crimping actuator 188 and move the crimpingactuator 188, and the cam actuator 181 extending therefrom, proximallyas illustrated in FIG. 12. Similar to the above, the proximal projection191 b extending from the proximal arm 190 b of the crimping actuator 188can be configured to contact the sidewall of the curved proximal end 116wherein the sidewall can guide the crimping actuator 188 downwardly androtate the crimping actuator 188 about the pivot 189. At such point, thefiring pin 184 may no longer be engaged with the crimping actuator 188,the cam actuator 181 may be fully retracted, and the firing nut 163 maycontinue to be retracted proximally relative to the crimping actuator188.

Further to the above, referring now to FIG. 11, the firing nut 163 canbe configured to re-engage the firing actuator 168 as the firing nut 163is being retracted proximally. As discussed above, the firing actuator168 is rotated downwardly when the firing actuator 168 reaches thedistal end 114 of the longitudinal slot 113 and, as a result, the firingactuator 168 may still be in its downwardly rotated position when thefiring nut 163 is retracted proximally to re-engage the firing actuator168. As illustrated in FIG. 11, the firing pin 172 extending from thefiring nut 163 can engage the proximal arm 170 b of the firing actuator168 and, as the firing nut 163 is further retracted, the firing nut 163can rotate the firing actuator 168 upwardly such that the projections171 a and 171 b extending from the arms 170 a and 170 b, respectively,can re-enter the longitudinal portion of the longitudinal slot 113.Thereafter, the firing nut 163 and can be retracted until the firingactuator 168 and the firing member 165 extending therefrom have beenreturned to their starting, or unfired, positions illustrated in FIG. 5.In such circumstances, the firing member 165 can be withdrawn from theclip cartridge 130 as the firing member 165 is retracted proximally bythe firing nut 163 such that a new clip 140 can be biased into thefiring chamber of the clip cartridge 130 by the biasing member 136. Oncethe firing member 165 and the firing actuator 168 have been retracted totheir starting positions and the next clip 140 has been positionedwithin the firing chamber, the firing drive 160 can be actuated onceagain in order to move the firing nut 163 and the firing member 165distally to advance the next clip 140 into the end effector 120.Likewise, the firing nut 163 can re-actuate the crimping drive 180 asthe firing nut 163 is moved distally once again in order to deform thenext clip 140. Thereafter, the firing nut 163 can retracted in order tore-set the crimping drive 180 and the firing drive 160 once again. Thisprocess can be repeated until a sufficient number of clips 140 have beenapplied to the targeted tissue and/or until the clips 140 containedwithin the clip cartridge 130 have been depleted. In the event thatadditional clips 140 are needed, the expended clip cartridge 130 can beremoved from the shaft 110 and a replacement clip cartridge 130containing additional clips 140 can be inserted into the shaft 110. Insome circumstances, an at least partially depleted clip cartridge 130can be replaced with an identical, or at least nearly identical,replacement clip cartridge 130 while, in other circumstances, the clipcartridge 130 can be replaced with a clip cartridge having more than orless than five clips 140 contained therein and/or a clip cartridgehaving clips other than clips 140 contained therein, for example.

Referring again to FIGS. 6-9, the firing nut 163 of the illustratedembodiment can be configured to become disengaged from the firingactuator 168 at the same time that the firing nut 163 becomes engagedwith the crimping actuator 188. Stated another way, the firing drive 160can be deactivated at the same time that the crimping drive 180 isactivated. In various circumstances, such timing can be achieved whenthe distal end 114 of the longitudinal slot 113 is aligned, or at leastsubstantially aligned, with the proximal end 116 of the secondlongitudinal slot 115, for example. In the illustrated embodiment and/orany other suitable embodiment, a lag can exist between the deactivationof the firing drive 160 and the activation of the crimping drive 180.Such a lag between the end of the firing stroke of the firing member 165and the beginning of the firing stroke of the cam actuator 181 can becreated, in some circumstances, to assure that the clip 140 has beenpositioned in its fully-seated position within the receiving chamber 122before the clip 140 is deformed by the cam actuator 181. In variouscircumstances, such a lag can be created when the distal end 114 of thelongitudinal slot 113 is positioned proximally with respect to theproximal end 116 of the second longitudinal slot 115, for example. Inthe illustrated embodiment and/or any other suitable embodiment, thedeactivation of the firing drive 160 may occur after the activation ofthe crimping drive 180. Such an overlap between the end of the firingstroke of the firing member 165 and the beginning of the firing strokeof the cam actuator 181 can be created, in some circumstances, to applyat least some inward pressure on the clip 140 as it is moved into itsfully-seated position within the receiving chamber 122 so as to reduceor eliminate relative movement between the clip 140 and the sidewalls ofthe receiving chamber 122, for example. In various circumstances, suchan overlap can be created when the distal end 114 of the longitudinalslot 113 is positioned distally with respect to the proximal end 116 ofthe second longitudinal slot 115, for example.

In the illustrated embodiment of FIG. 1 and/or any other suitableembodiment, turning now to FIG. 17, a clip cartridge, such as clipcartridge 230, for example, can comprise a pusher plate 248 positionedintermediate the biasing member 136 and the top-most clip 140 stackedwithin the clip cartridge 230. The pusher plate 248 can be rigid, or atleast substantially rigid, and can comprise a first bearing surfaceagainst which the biasing member 136 can apply a biasing force. Thepusher plate 248 can also comprise a second bearing surface which cantransmit the biasing force to the top surface 145 of the top-most clip140. The pusher plate 248 can be comprised of a sheet of stainless steelmaterial, for example, although the pusher plate 248 can comprise anysuitable shape and can be comprised of any suitable material. In certaininstances, the pusher plate 248 may not be attached to the biasingmember 136 while, in other instances, the pusher plate 248 can beaffixed to the biasing member 136 such that the pusher plate 248 doesnot become dislodged from the cartridge housing 132. In variouscircumstances, the pusher plate 248 can be sized and configured suchthat it cannot pass through the proximal opening 133 and/or the distalopening 137 defined in the cartridge housing 132.

In the illustrated embodiment of FIG. 1 and/or any other suitableembodiment, turning now to FIGS. 18 and 19, a clip cartridge, such asclip cartridge 330, for example, can comprise a lockout member which canbe positioned within the firing chamber 149 of the clip cartridge 330after all of the clips 140 contained within the clip cartridge 330 havebeen ejected from the cartridge 330. The lockout member can comprise alockout plate 348 which can be positioned intermediate the biasingmember 136 and the top surface 145 of the top-most clip 140 containedwithin the clip cartridge 330. In use, further to the above, the clips140 can be sequentially positioned in the firing chamber 149 of the clipcartridge 130 and then advanced distally out of the clip housing 132wherein, after the last clip 140 has been advanced out of the cliphousing 132 and the firing member 165 has been withdrawn from the clipcartridge 130, the biasing member 136 can bias the lockout plate 348against the shelves 135. In such a position, the lockout plate 348 canbe aligned with the proximal opening 133 and the distal opening 137 suchthat the firing member 165 cannot enter, or at least substantiallyenter, the clip cartridge 130. In such circumstances, the lockout plate348 can block the firing member 165 from entering into and passingthrough the housing 132 and, as a result, prevent the inadvertent firingof the clip applier 100 after the clip cartridge 130 has run out ofclips. In the event that the operator of the clip applier 100 were toactuate the firing drive 160 and attempt to advance the firing member165 into the spent clip cartridge 130, the firing member 165 wouldcontact and abut the lockout plate 348 wherein, in such circumstances, acompressive load can be created within the firing member 165. The clipapplier 100 can further include a clutch which can be configured to slipand operably disconnect the motor from the drive screw 161 when thecompressive load created within the firing member 165 exceeds a certainor predetermined amount. In addition to or in lieu of a clutch, themotor and/or motor controller of the clip applier 100 which operates thefiring drive 160, for example, can comprise a load sensor configured todetect the load generated within the firing member 165 and, when theload created within the firing member 165 exceeds a certain orpredetermined amount, the voltage and/or current supplied to the motorcan be switched off and/or reduced. In any event, the lockout plate 348can be sized and configured such that the lockout plate 348 cannot bedislodged through the distal opening 137 and/or the proximal opening 133when the firing member 165 contacts the lockout plate 348. In order touse the clip applier 100 once again, the operator of the clip applier100 can remove the spent cartridge 330 from the shaft 110 and insert anew clip cartridge 330, for example, into the shaft 110. At such point,a clip 140 may be positioned within the firing chamber 149 of the newclip cartridge 330 and the firing member 165 can be advanced distallyinto the new clip cartridge 330 to deploy the clip 140 as describedabove.

In the illustrated embodiment of FIG. 1 and/or any other suitableembodiment, referring now to FIGS. 20 and 21, a clip cartridge, such asclip cartridge 430, for example, can comprise guides which can beconfigured to limit or confine the movement of a lockout member withinthe clip cartridge 430. Similar to the above, the lockout member cancomprise a lockout plate 448, for example, which can be positionedintermediate the biasing member 136 and the top surface 145 of thetop-most clip 140 contained within the housing 432 of the clip cartridge430. In use, similar to the above, the lockout plate 448 can beprogressively pushed downwardly into the firing chamber 149 as the clips140 are sequentially ejected from the clip cartridge 430. The lockoutplate 448 can be sized and configured such that it is closely receivedwithin the cartridge housing 432 and such that relative lateral movementbetween the lockout plate 448 and the housing 432 can be limited inorder to reduce, or prevent, the possibility of the lockout plate 448becoming misaligned within the clip cartridge 430. In the event that thelockout plate 448 were to become misaligned within the clip cartridge430, the lockout plate 448 may bind within the housing 432 and preventthe biasing member 136 from applying an appropriate biasing force to thestack of clips 140, for example. As illustrated in FIGS. 20 and 21, thelockout plate 438 can further comprise guide members 447 extendingtherefrom which can be received within guide slots 446 defined in thecartridge housing 432. The guide members 447 and the guide slots 446 canbe sized and configured such that the guide members 447 are closelyreceived within the guide slots 446 and such that relative lateralmovement between the lockout plate 438 and the cartridge housing 432 canbe limited. Each of the guide slots 446 can be defined by opposingsidewalls 445 which can define a distance therebetween which is equal toor slightly larger than the width of the guide member 447 positionedtherein such that the guide member 447 can slide between the opposingsidewalls 445 between the top 443 and the bottom 444 of the guide slot446. Thus, while the guide members 447 and the guide slots 446 can beconfigured to limit lateral movement therebetween, as outlined above,the guide members 447 and the guide slots 446 can be configured topermit relative movement between the lockout plate 438 and the cartridgehousing 432 along a predetermined path parallel to or collinear with thesupply axis 138, for example. When the lockout plate 438 is pushed intothe firing chamber 149 by the biasing member 136, the lockout plate 438can inhibit the advancement of the firing member 165 and the operationof the clip applier 100, as outlined above, until the spent clipcartridge 430 is replaced with another suitable clip cartridge.

In the illustrated embodiment of FIG. 1 and/or any other suitableembodiment, as discussed above, the drive screw 161 can be rotated in afirst direction to advance the firing nut 163 distally and rotated in asecond, or reverse, direction to retract the firing nut 163 proximally.In order to rotate the drive screw 161 in the first and seconddirections, the electric motor operably coupled with the drive screw 161can be operated in corresponding first and second directions. In theillustrated embodiment of FIG. 1 and/or any other suitable embodiment, aclip applier can utilize a motor which is operated in only a firstdirection wherein the rotation of the motor in such a single directioncan be utilized to advance a firing nut distally and retract the firingnut proximally. Turning now to FIGS. 22-26, the output of an electricmotor can be transmitted to a drive system 560 via a transmission system550. The transmission system 550 can comprise an input shaft 552 whichis operated in a single direction wherein the transmission system 550can be switchable or shiftable between a first state, or configuration,in which the transmission system 550 rotates a drive screw 561 of thedrive system 560 in a first direction and a second state, ofconfiguration, in which the transmission system 550 rotates the drivescrew 561 in a second, or opposite, direction. The first state of thetransmission system 550 is depicted in FIGS. 22-24 and the second stateof the transmission system 550 is depicted in FIGS. 25 and 26.

Referring again to FIGS. 22-24, the input shaft 552 can comprise aninput gear 551 mounted thereto which is operably coupled, or meshinglyengaged, with a shifter gear 553 such that the rotation of the inputshaft 552 is transmitted to the shifter gear 553. With regard to all ofthe gears discussed herein, gears which are operably coupled ormeshingly engaged with one another can comprise any suitable arrangementof teeth, for example, which can transmit the rotation of one gear tothe other. When the input shaft 552 is rotated in the first direction,the shifter gear 553 is rotated in the second, or opposite, direction.In the first state of the transmission system, the shifter gear 553 isin a first position in which the shifter gear 553 is operably coupledwith an intermediate gear 554 wherein, when the shifter gear 553 isrotated in the second direction by the input gear 551, as discussedabove, the intermediate gear 554 is rotated in the first direction.Although not illustrated, the intermediate gear 554 can be rotatablysupported within the shaft 110 of the clip applier 100, for example. Theintermediate gear 554 can also be operably coupled with an output gear555 mounted to the drive screw 561 such that the rotation of theintermediate gear 554 can be transmitted to the output gear 555. Whenthe intermediate gear 554 is driven in the first direction by theshifter gear 553, as described above, the intermediate gear 554 candrive the output gear 555 and the drive screw 561 in the seconddirection. Similar to the above, the firing nut 563 can be operablycoupled with the drive screw 561 and suitably constrained within theshaft 110 such that, when the drive screw 561 is rotated in the seconddirection, the firing nut 563 is advanced distally as indicated by thearrow D.

Similar to the above, the firing nut 563 can be advanced to itsdistal-most position, illustrated in FIG. 24, in order to advance a clip140 from the clip cartridge 130 into the end effector 120 and crimp theclip 140 as described above. As illustrated in FIGS. 23 and 24, thefiring nut 563 can further comprise a cam bar 569 extending therefromwhich can be configured to shift the transmission system 550 from itsfirst state to its second state. Upon comparing FIG. 24 and FIG. 25, thereader will note that the shifter gear 553 is movable between a firstposition in which the transmission system 550 is in its first state anda second position in which the transmission system 550 is in its secondstate. More particularly, the shifter gear 553 is mounted to a shifter556 which is rotatable about the input shaft 552 such that the shiftergear 553 can be rotated from its first position in which the shiftergear 553 is operably engaged with the input gear 551 and theintermediate gear 554 and its second position in which the shifter gear553 is operably disengaged from the intermediate gear 554. Although theshifter gear 553 is operably disengaged from the intermediate gear 554when the shifter gear 553 is in its second position, the shifter gear553 can be operably coupled with the input gear 551 and the output gear555 in order to transmit rotary motion from the input shaft 552 to thedrive screw 561. As illustrated in FIGS. 24 and 25, the shifter 556 cancomprise a central aperture through which the input shaft 552 canextend; however, the shifter 556 may not be operably engaged with theinput shaft 552 and, as a result, the rotation of the input shaft 552may not rotate the shifter 556 and, likewise, the rotation of theshifter 556 may not rotate the input shaft 552. In any event, theshifter 556 can further comprise a cam follower 558 extending therefromwhich can be engaged by a cam 568 defined on the cam bar 569 as thefiring nut 563 is advanced distally. When the cam 568 engages the camfollower 558, the cam 568 can rotate the shifter 556 and the shiftergear 553 between its first position and its second position as describedabove.

When the shifter gear 553 is in its second position and the transmissionsystem 550 is in its second state, as described above, the input shaft552 and the drive screw 561 can both be rotated in the first direction.More particularly, the input shaft 552, when rotated in the firstdirection, can rotate the input gear 551 in the first direction and, asthe shifter gear 553 is directly engaged with the input gear 551, theshifter gear 553 will be rotated in the second direction. The readerwill note that the shifter gear 553 rotates in the second direction whenthe transmission system 550 is in its second state as compared to thefirst, or opposite, direction when the transmission system 550 is in itsfirst state. Upon comparing FIGS. 24 and 25, further to the above, thereader will appreciate that the intermediate gear 554 is no longeroperably positioned intermediate the input gear 551 and the shifter gear553 when the transmission system 550 is in its second state therebyaccounting for the different directions of rotation. As the shifter gear553 is operably engaged with the input gear 551 and the output gear 555when the shifter gear 553 is in its second position, the shifter gear553 can rotate the output gear 555, and the drive screw 561 coupled tothe output gear 555, in the first direction. When the drive screw 561 isrotated in the first direction, as illustrated in FIGS. 25 and 26, thefiring nut 563 can be retracted proximally to permit the end effector120 to be reopened and to retract the firing member 165. Referringprimarily to FIG. 26, the firing nut 563 can further comprise a secondcam bar 567 extending therefrom comprising a cam 566 which can beconfigured to contact the cam follower 558 of the shifter 556 as thefiring nut 563 is retracted proximally into its fully-retractedposition. In such circumstances, the cam 566 can push the shifter 556back into its first position and into operative engagement with theintermediate gear 554 such that the transmission system 550 can be resetinto its first state and the clip applier 100 can be actuated onceagain.

As discussed above, the firing drive of the clip applier 100 can beoperated by a surgical instrument system comprising an electric motor. Arobotic surgical instrument system 20 is illustrated in FIG. 27 and cancomprise a plurality of movable arms 30. Each arm 30 can comprise anactuator module 32 comprising an electric motor configured to supply therotary motion to the shaft 110 of a clip applier 100, and/or any othersuitable surgical instrument. Referring now to FIG. 28, an end effector620 may be selectively engageable with and disengageable from anactuator shaft 610 of a clip applier wherein the end effector 620 cancomprise a proximal end 621 which can be coupled to a distal end 611 ofthe shaft 610. The proximal end 621 of the end effector 620 can comprisean outer housing 629, a frame extending through the outer housing 629,an outer drive shaft extending through the frame, and an inner driveshaft extending through the outer drive shaft. Similarly, the distal end611 of the shaft 610 can comprise an outer housing 619, a frame 663extending through the outer housing 619, an outer drive shaft 662extending through the frame 663, and an inner drive shaft 661 extendingthrough the outer drive shaft 662. With regard to the distal end 611 ofthe shaft 610, the frame 663, the outer drive shaft 662, and the innerdrive shaft 661 can each comprise a portion of a tongue connector 613extending therefrom and a portion of a connector groove 612 definedtherein, wherein the tongue connector 613 can be configured to bereceived within a tongue groove 623 defined in the proximal end 621 ofthe end effector 620, and wherein the tongue groove 612 can beconfigured to receive a tongue connector 622 extending from the proximalend 621 of the end effector 620. Similar to the tongue connector 613which extends across the frame 663, the outer drive shaft 662, and theinner drive shaft 661 of the distal shaft end 611, the tongue connector622 can extend across the frame, the outer drive shaft, and the innerdrive shaft of the proximal end 621 of the end effector 620. Also,similar to the tongue groove 612 which extends across the frame 663, theouter drive shaft 662, and the inner drive shaft 661 of the distal shaftend 611, the tongue groove 623 can extend across the frame, the outerdrive shaft, and the inner drive shaft of the proximal end 621 of theend effector 620. In the configuration depicted in FIG. 28, the tongueconnector 622 of the end effector 620 can be slid laterally into thetongue groove 612 of the shaft 610 at the same time that the tongueconnector 613 of the shaft 610 is slid laterally into the tongue groove623 of the end effector 620. Owing to such assembly, the frame of theend effector 620 can be securely coupled to the frame 663 of the shaft610, the outer drive shaft of the end effector 620 can be operablycoupled to the outer drive shaft 662 of the shaft 110, and the innerdrive shaft of the end effector 620 can be operable coupled to the innerdrive shaft 661 of the shaft 110. The reader will note that the portionsof the tongue connector 612 are aligned with one another, the portionsof the tongue groove 613 are aligned with one another, the portions ofthe tongue groove 622 are aligned with one another, and the portions ofthe tongue connector 623 are aligned with one another when the endeffector 620 is assembled to the shaft 610. Once assembled, the outerdrive shaft 662 of the shaft 110 can rotate the outer drive shaft of theend effector 620, and the inner drive shaft 661 of the shaft 610 canrotate the inner drive shaft of the end effector 620. When the outerdrive shaft 662 and/or the inner drive shaft 661 are rotated, theportions of the tongue connector 612, the portions of the tongue groove613, the portions of the tongue groove 622, and the portions of thetongue connector 623 may no longer be aligned. In order to remove theend effector 620 from the shaft 610, the inner drive shaft 661 and/orthe outer drive shaft 662 can be rotated into one or more positions inwhich the tongue connectors 612 and 623 and the tongue grooves 613 and622 are sufficiently aligned.

Referring again to FIG. 28, the outer housing 619 of the shaft 610 canfurther comprise a stop 614 which can be configured to limit the lateralmovement of the end effector 620 as the end effector 620 is being slidtransversely onto the distal end 611 of the shaft 610. The stop 614 canprovide a datum from which the inner drive shaft of the end effector 620and the inner drive shaft 661 of the shaft 610 are aligned alonglongitudinal axis 615, the outer drive shaft of the end effector 620 andthe other drive shaft 662 of the shaft 610 are aligned alonglongitudinal axis 615, and/or the frame of the end effector 620 and theframe 663 of the shaft 610 are aligned along the longitudinal axis 615.Further to the above, the inner drive shaft 661 can extend into anactuator module 632 which can comprise an electric motor and/or geartrain 664 operably coupled with the inner drive shaft 661 configured torotate the inner drive shaft 661. Furthermore, the actuator module 632can comprise a second electric motor and gear train operably engagedwith the second drive shaft 662 configured to drive the second driveshaft 662. As described in greater detail below, a second electric motorcan be utilized to articulate the end effector 620. Also, further to theabove, the outer housing 619 and/or the frame 663 of the shaft 610 canfurther comprise a gear 617 mounted thereto which is operably engagedwith an electric motor and gear train 618 which can be configured torotate the shaft 610 and the end effector 620 about the longitudinalaxis 615. For instance, if the electric motor and gear train 618 areoperated in a first direction, the shaft 610 and the end effector 620can be rotated about the axis 615 in a clockwise direction while, if theelectric motor and gear train 618 are operated in a second direction,the shaft 610 and the end effector 620 can be rotated about the axis 615in a counter-clockwise direction in order to position and orient the endeffector 620.

As discussed above, the end effector 620 can be selectively attached toand detached from the shaft 610. The reader will note that theprinciples discussed in connection with the end effector 620 and shaft610 can be equally applied to the end effector 120 and the shaft 110 ofthe embodiment disclosed in FIG. 1, among others. That said, referringagain to FIG. 27, one of the robotic arms 30 can be selectively engagedwith an end effector 120 of a clip applier or, alternatively, any othersuitable end effector, such as the end effector of a surgical stapler,for example. In such circumstances, an end effector 120 can beselectively interchanged with another end effector and, as a result, asingle robotic arm 30 can be utilized to perform more than one function.Stated another way, the clip applier 100 can comprise a replaceableloading unit which can be replaced by, or interchanged with, anotherclip applier loading unit and/or any other suitable replaceable loadingunit. Turning now to FIG. 29, the end effector 120 and the shaft 110 ofthe clip applier 100 can be utilized with a surgical instrument systemcomprising a handle 700. The handle 700 can comprise an actuator 701which can be operated, or squeezed toward grip 702, in order to apply arotary motion to the drive screw 161 as described above. In some cases,the rotation of the actuator 701 can be mechanically transmitted to thedrive screw 161 while, in other cases, the actuator 701 can operate amotor operably coupled to the drive screw 161.

Further to the above, the end effector 120 and the shaft 110 of the clipapplier 100 can be aligned along a longitudinal axis of the clip applier100. Turning now to FIG. 30, the end effector 120 and/or the shaft 110can further comprise an articulation joint 101 which can be configuredto permit the end effector 120 to be articulated relative to thelongitudinal axis of the clip applier 100. The shaft 110 can comprise anouter housing, or frame portion, 119 which can comprise a proximal end102 and can comprise a distal portion of the articulation joint 101. Theproximal end 102 can comprise a spherical, or an at least substantiallyspherical, end 102, for example, which can be received within aspherical, or an at least substantially spherical, cavity 104 defined inan articulation joint member 103. The articulation joint member 103 canalso comprise a spherical, or at least substantially spherical, end 105,for example, which can be received within a spherical, or an at leastsubstantially spherical, cavity 107 defined in a shaft frame portion106. The proximal end 102 of the shaft 110 can be at least partiallycaptured within the cavity 104 such that the proximal end 102 cannot bereadily removed from the cavity 104. That said, the proximal end 102 andthe cavity 104 can be sized and configured to permit the proximal end102 to be rotated in any suitable direction within the cavity 104. Asalso illustrated in FIG. 30, the clip applier 100 can further comprisearticulation controls 108 a and 108 b, for example, which can extendthrough the articulation joint 101 and can comprise distal ends mountedwithin mounting apertures 109 a and 109 b, respectively, defined withinthe proximal end 102 of the shaft housing 119. In use, the articulationcontrols 108 a and 108 b can be pushed and/or pulled in order to movethe proximal end 102 within the cavity 104. Further to the above, theend 105 of the articulation joint member 103 can be at least partiallycaptured within the cavity 107 defined in the shaft frame portion 106such that the end 105 cannot be readily removed from the cavity 107.That said, the end 105 and the cavity 107 can be sized and configured topermit the end 105 to be rotated in any suitable direction within thecavity 107 when the shaft end 102 is pushed and/or pulled by theactuators 108 a and 108 b as described above.

Further to the above, referring again to FIG. 30, the drive screw 161can be rotated by an input shaft, such as input shaft 152, for example.The input shaft 152 can extend through an aperture 156 defined withinthe shaft frame portion 106, the articulation joint member 103, and theproximal end 102 of the shaft housing 119. The input shaft 152 cancomprise an input gear 151 mounted to the distal end thereof which canbe operably coupled with an output gear 155 mounted to the proximal endof the drive screw 161. In use, the input shaft 152 can be rotated bythe electric motor, described above, wherein the input shaft 152 canrotate the drive screw 161. As outlined above, the articulation joint101 can be configured to permit the end effector 120 and at least aportion of the shaft 110 to be articulated relative to a longitudinalaxis defined by the clip applier 100. In order to accommodate suchmovement, at least the portion of the input shaft 152 extending throughthe articulation joint 101 can be sufficiently flexible.

Turning now to FIGS. 31-34, the articulation actuators 108 a and 108 bcan be operated by an actuator module such as module 832, for example.Referring primarily to FIG. 31, the actuator module 832 can comprise arotatable articulation driver 833 which can be configured to push andpull the articulation actuators 108 a and 108 b. The articulation driver833 can comprise a cylindrical, or an at least substantiallycylindrical, collar 835 including an aperture 837 which can beconfigured to receive at least a portion of the shaft frame 106 thereinin order to rotatably support the collar 835. The articulation driver833 can further comprise an input gear portion 834 which can be operablycoupled with an electric motor and gear train 831 of the module 832wherein, when the electric motor and gear train 831 are actuated, thearticulation driver 833 can be rotated about the shaft frame 106.Referring primarily to FIGS. 32 and 34, the articulation driver 833 canfurther comprise two cam slots defined in the sidewall of the collaraperture 837, although the reader will note that only one cam slot 835 ais illustrated in the provided views. The cam slot 835 a is configuredto receive a cam follower 838 a extending from the articulation driver108 a wherein the cam follower 838 a is configured to slide within thecam slot 835 a. When the articulation driver 833 is rotated, the helicalcontour of the cam slot 835 a, for example, can be configured to pushthe cam follower 838 a distally or pull the cam follower 838 aproximally, depending on the direction in which the articulation driver833 is rotated. As a result of the proximal or distal movement of thecam follower 838 a, the cam actuator 108 a can be moved proximally ordistally, respectively. While not illustrated, the articulation driver108 b can comprise a cam follower, similar to the cam follower 838 a,which can be configured to slide within the other cam slot discussedabove. The other cam slot can be configured such that, when thearticulation actuator 108 a is driven distally by the articulationdriver 833 when the articulation driver 833 is rotated in a firstdirection, the articulation actuator 108 b can be pulled proximally.Similarly, the other cam slot can be configured such that, when thearticulation actuator 108 a is pulled proximally by the articulationdriver 833 when the articulation driver 833 is rotated in a seconddirection, the articulation actuator 108 b can be driven distally.Referring primarily to FIG. 32, the shaft frame portion 106 can compriseclearance slots 839 defined therein through which the cam followers canextend. Although the above features have been discussed in connectionwith an actuator module 832, such features could be used in connectionwith the other actuator modules disclosed herein.

FIGS. 35A, 35B, and 35C depict a clip applier 70100 in accordance withat least one embodiment. The clip applier 70100 is similar to the clipapplier 100 in many respects, most of which will not be repeated hereinfor the sake of brevity. Similar to the clip applier 100, the clipapplier 70100 comprises an end effector 70120, a shaft, a clipcartridge, and a firing member 70165. The clip cartridge comprises aplurality of clips 70140 removably stored therein. The end effector70120 comprise a first jaw 70123 a and a second jaw 70123 b wherein thefirst jaw 70123 a and the second jaw 70123 b at least partially define areceiving chamber 70122. Further, the first jaw 70123 a and the secondjaw 70123 b are pivotally coupled to the shaft by a pin 70125 such thatthe first jaw 70123 a and the second jaw 70123 b are movable relative toeach other between an open position (FIG. 35B) and a closed position(FIG. 35A). The first jaw 70123 a and the second jaw 70123 b are movablebetween the open position and the closed position by a crimping drive70180 (see FIGS. 36-38). Other embodiments are envisioned where thefirst jaw 70123 a and the second jaw 70123 b are pivotally coupled tothe shaft utilizing at least one pin similar to the first jaw 125 a andsecond jaw 125 b depicted in FIG. 1. The first jaw 70123 a and thesecond jaw 70123 b include pre-form features, such as protrusions 70126a and 70126 b which are discussed in further detail below.

In use, the firing member 70165 advances a clip 70140 from the clipcartridge onto the protrusions 70126 a and 70126 b as depicted in FIG.35A. In this position, the clip 70140 is in a pre-formed configuration.The width of the clip 70140 in the pre-formed configuration can be0.080″ preferably. When the first jaw 70123 a and the second jaw 70123 bare moved from the closed position to the open position, the protrusions70126 a and 70126 b expand the clip 70140 to an expanded configurationas depicted in FIG. 35B. The width of the clip 70140 in the expandedconfiguration can be 0.210″ preferably. During the transition of theclip 70140 from the pre-formed configuration to the expandedconfiguration, the firing member 70165 supports the backside of the clip70140. More specifically, the firing member 70165 includes angledsurfaces 70165 a and 70165 b which provide support for the backside ofthe clip 70140 as the clip 70140 expands. Further, as the clip 70140 isexpanded, the firing member 70165 can be advanced to allow the angledsurfaces 70165 a and 70165 b to continue to maintain contact against thebackside of the clip 70140 as the clip 70140 expands. Once in theexpanded configuration, the clip 70140 is advanced into the receivingchamber 70122 by the firing member 70165. The protrusions 70126 a and70126 b include angled portions which allow the clip 70140 to slide overthe protrusions 70126 a and 70126 b when the clip 70140 is advanced bythe firing member 70165. After the clip 70140 has been advanced into thereceiving chamber 70122, the firing member 70165 is retracted, and thecrimping drive 70180 is actuated to transition the first jaw 70123 a andthe second jaw 70123 b to the closed position depicted in FIG. 35A tocrimp the clip 70140 positioned in the receiving chamber 70122. Afterthe clip 70140 is crimped, another clip 70140 can be advanced onto theprotrusions 70126 a and 70126 b by the firing member 70165. When thefirst jaw 70123 a and the second jaw 70123 b are moved from the closedposition to the open position by the crimping drive 70180, the clip70140 that has been crimped in the receiving chamber 70122 will bereleased from the receiving chamber 70122 and the clip 70140 that wasadvanced onto the protrusions 70126 a and 70126 b will be expanded intoto the expanded configuration by the protrusions 70126 a and 70126 b ofthe first and second jaws 70123 a and 70123 b. Interaction between thecrimping drive 70180 and the first and second jaws 70123 a and 70123 bis discussed in further detail below.

FIGS. 36-38 depict the clip applier 70100 as described above. Inaddition, FIGS. 36-38 further depict the interaction between thecrimping drive 70180 and the first and second jaws 70123 a and 70123 b.The crimping drive 70180 comprises a first crimping drive pin 70180 aand a second crimping drive pin 70180 b protruding therefrom. The firstjaw 70123 a comprises a first jaw cam 70124 a extending therefrom andthe second jaw 70123 b comprises a second jaw cam 70124 b extendingtherefrom. In use, the crimping drive 70180 is movable between a fullyretracted position (FIG. 38), a home position (FIG. 37), and afully-fired position (FIG. 36). The fully-fired position can preferablybe 0.300″ distal to the home position. The fully retracted position canpreferably be 0.050″ proximal to the home position. Other embodimentsare envisioned with different distances between the home position, thefully retracted position, and the fully-fired position. The crimpingdrive 70180 cammingly engages outer surfaces of the first jaw 70123 aand the second jaw 70123 b to transition the first jaw 70123 a and thesecond jaw 70123 b to a closed position when the crimping drive 70180 ismoved into the fully-fired position (FIG. 36)—similar to the interactionbetween the crimping drive 180 and the first and second jaws 123 a and123 b described above. In the home position (FIG. 37), the first andsecond crimping drive pins 70180 a and 70180 b engage the first jaw cam70124 a and the second jaw cam 70124 b, respectively, such that thefirst jaw 70123 a and the second jaw 70123 b are moved toward the openposition to release a crimped clip 70140 from the first and second jaws70123 a and 70123 b. When the crimping drive 70180 is in the homeposition, another clip 70140 can be advanced onto the protrusions 70126a and 70126 b as discussed above. Further, as the crimping drive 70180is moved from the home position (FIG. 37) to the fully retractedposition (FIG. 38) the first crimping drive pin 70180 a and the secondcrimping drive pin 70180 b transition the first jaw 70123 a and thesecond jaw 70123 b towards the open position, and thus, the clip 70140positioned around the protrusions 70126 a and 70126 b is expanded intothe expanded configuration, as discussed above. Alternative embodimentsare envisioned in which a crimped clip 70140 is released from the firstand second jaws 70123 a and 70123 b and, at the same time, another clip70140 positioned on the protrusions 70126 a and 70126 b is leastpartially expanded when the crimping drive is moved from the closedposition to the home position.

FIGS. 39 and 40 depict a clip applier 70150 in accordance with at leastone embodiment. The clip applier 70150 comprises a frame 70155, a firingmember 70160, a first jaw 70170 a, and a second jaw 70170 b. The firstjaw 70170 a and the second jaw 70170 b are pivotally coupled to theframe 70155 such that the first jaw 70170 a and the second jaw 70170 bare movable relative to each other. The clip applier 70150 is configuredto receive various types of clip cartridges, such as clip cartridge70130 depicted in FIG. 39, for example. The clip cartridge 70130comprises a cartridge body 70132 including a first cartridge jaw 70132 aand a second cartridge jaw 70132 b that oppose each other. When the clipcartridge 70130 is attached to the frame 70155 of the clip applier70150, the first cartridge jaw 70132 a biases the first jaw 70170 atowards the second jaw 70170 b, and the second cartridge jaw 70132 bbiases the second jaw 70170 b towards the first jaw 70170 a. Thus, whenthe clip cartridge 70130 is attached to the clip applier 70150, thefirst and second jaws 70170 a and 70170 b are approximated to form areceiving chamber 70175. The clip cartridge 70130 further comprises aplurality of clips 70136 removably stored in a clip housing 70134. Theclip cartridge 70130 further includes biasing members, such as springs70138 for example, configured to bias the clips 70136 out of the cliphousing 70134 into the receiving chamber 70175. Once in the receivingchamber 70175, a clip 70136 can be advanced by the firing member 70160into a crimping chamber in the distal end of the first and second jaws70170 a and 70170 b. A clip 70136 positioned in the crimping chamber canthen be crimped when the first jaw 70170 a and the second jaw 70170 bare moved towards each other.

FIG. 40 depicts a different clip cartridge 70130′ positioned in the clipapplier 70150. The clip cartridge 70130′ is similar to clip cartridge70130 discussed above, except for the differences discussed below. Theclip cartridge 70130′ is configured to store clips 70136′ which aresmaller than clips 70136. Other embodiments are envisioned where theclip cartridge 70130′ is configured to store clips that are larger thanclips 70136. In any event, clip cartridge 70136′ comprises, one, a cliphousing 70134′ which stores the clips 70136′ and, two, biasing members,such as springs 70138′ for example, which bias the stored clips 70136′into a receiving chamber 70175′. Further, the clip cartridge 70130′comprises a cartridge body 70132′, a first cartridge jaw 70132 a′, and asecond cartridge jaw 70132 b′ opposing the first cartridge jaw 70132 a′.The first cartridge jaw 70132 a′ and the second cartridge jaw 70132 b′extend further inward toward each other as compared to the firstcartridge jaw 70132 a and the second cartridge jaw 70132 b of the clipcartridge 70130. Stated another way, the gap between the first cartridgejaw 70132 a′ and the second cartridge jaw 70132 b′ is smaller than thegap between the first cartridge jaw 70132 a and the second cartridge jaw70132 b. When the clip cartridge 70130′ is attached to the clip applier70150, the receiving chamber 70175′ defined between the first jaw 70170a and the second jaw 70170 b will be smaller than the receiving chamber70175. By changing the distance between the first cartridge jaw and thesecond cartridge jaw of the clip cartridges 70130 and 70130′, varioussizes of receiving chambers can be created. The clip cartridges 70130and 70130′ can therefore be modified to approximate the first jaw 70170a and the second jaw 70170 b of the clip applier 70150 to receive anysuitable clip size.

FIG. 41 depicts a clip applier 70200 in accordance with at least oneembodiment. The clip applier comprises a shaft 70210 extending from ahousing, an end effector 70220 extending from the shaft 70210, a feedermember 70230 configured to move through the clip applier 70200 inresponse to rotary motions generated in the housing, and a clip magazine70240. The end effector comprises a pair of jaws 70225 configured tomove relative to each other between open and closed positions. The clipmagazine 70240 is not removable from the clip applier 70200; however,other embodiments are envisioned where the clip magazine 70240 isremovable and/or replaceable. The clip magazine 70240 comprises a firstlayer 70246 of clips 70244 and a second layer 70248 of clips 70244stored within the clip magazine 70240. The first layer 70246 of clips70244 are in a feeding position from which they can be ejected from theclip magazine 70240. The second layer 70248 of clips 70244 are storedabove the first layer 70246 of clips 70244 in a storage position fromwhich they cannot be ejected from the clip magazine 70240. Each of thefirst layer 70246 and second layer 70248 comprises three clips 70244,however, other embodiments are envisioned with more or less than threeclips. The first and second layers 70246 and 70248 are separated by adivider member, such as a divider plate 70249. The clip magazine 70240further comprises a top plate 70243 and biasing members 70242. The topplate 70243 rests on top of the second layer 70248 of clips 70244. Thebiasing members 70242 bias the top plate 70243 toward the top of thesecond layer 70248 of clips 70244 and, thus, bias the second layer 70248of clips 70244 toward the divider plate 70249. The divider plate 70249rests on top of the first layer 70246 of clips 70244 and a distalprotrusion 70232 of the feeder member 70230. The distal protrusion 70232extends above the feeder member 70230. Operation of the clip applier70200 is discussed in further detail below.

In use, the feeder member 70230 is translated distally to push the firstlayer 70246 of clips 70244 toward the end effector 70220 and out of theclip magazine 70240. As the first layer 70246 of clips 70244 is beingadvanced from the clip magazine 70240, the divider plate 70249 issupported by the distal protrusion 70232 of the feeder member 70230 andany of the clips 70244 which haven't been fully ejected from the clipmagazine 70240. Once the feeder member 70230 has advance all of theclips 70244 in the first layer 70246 out of the clip magazine 70240, thedivider plate 70249 is biased by the biasing members 70242 into a recess70233 in the feeder member 70230. The recess 70233 is defined betweenthe distal protrusion 70232 of the feeder member 70230 and a proximalprotrusion 70234 of the feeder member 70230 extending upward from theproximal end of the feeder member 70230. Once the divider plate 70249 isseated in the recess 70233, the feeder member 70230 and divider plate70249 can be retracted together proximally out of the clip magazine70240. After the feeder member 70230 and divider plate 70249 arecompletely retracted out of the clip magazine 70240, the second layer70248 of clips 70244 is biased by the biasing members 70242 into thefeeding position (i.e., where the first layer 70246 of clips 70244 usedto be). The feeder member 70230 and divider plate 70249 can be advancedtogether toward the end effector to eject the second layer 70248 ofclips 70244 from the clip magazine 70240. The reader will appreciatethat all of the clips 70244 in the first layer 70246 and/or second layer70248 are not ejected at the same time, rather, they are ejected one ata time to allow each clip 70244 to be sequentially crimped by the pairof jaws 70255 of the end effector 70220. The above being said, otherembodiments are envisioned in which more than one clip 70244 can beejected at a time.

FIG. 42A depicts a clip applier 70250 in accordance with at least oneembodiment. The clip applier 70250 comprises an elongate shaft 70260extending from a housing, a clip cartridge 70270 extending from theelongate shaft 70260, and an end effector 70280 extending from the clipcartridge 70270. The elongate shaft 70260 and the clip cartridge 70270define a shaft axis SA. The elongate shaft 70260 comprises a firstinwardly extending detent 70264 a and a second inwardly extending detent70264 b opposing the first inwardly extending detent 70264 a. The firstand second inwardly extending detents 70264 a and 70264 b extendinwardly toward the shaft axis SA and can flex outwardly away from theshaft axis SA when a force is applied thereto. The elongate shaft 70260further comprises a top notch 70262 a and a bottom notch 70262 bopposing the top notch 70262 a. The top notch 70262 a and the bottomnotch 70262 b are located in the distal end of the elongate shaft 70260.The clip cartridge 70270 is releasably attachable to the distal end ofthe elongate shaft 70260 as discussed in further detail below.

The clip cartridge 70270 comprises a top protrusion 70272 a and a bottomprotrusion 70272 b opposite the top protrusion 70272 a. The topprotrusion 70272 a and the bottom protrusion 70272 b extend from theclip cartridge 70270 away from the shaft axis SA. The clip cartridge70270 further comprises a first slot and a second slot 70274 b in theproximal end of the clip cartridge 70270. The first slot and the secondslot 70274 b oppose one another. The clip cartridge 70270 is configuredto slide into the inner diameter of the elongate shaft 70260 such thatthe top protrusion 70272 a slides into the top notch 70262 a, the bottomprotrusion 70272 b slides into the bottom notch 70262 b, the firstinwardly extending detent 70264 a engages the first slot of the clipcartridge 70270, and the second inwardly extending detent 70264 bengages the second slot 70274 b of the clip cartridge 70270 to attachthe clip cartridge 70220 to the elongate shaft 70260. After the clipcartridge 70270 is attached to the elongate shaft 70260, the elongateshaft 70260 and clip cartridge 70270 are fixedly coupled such that theycan rotate together about the shaft axis SA. Further, the clip cartridge70270 can be detached from the elongate shaft 70260 by a clinician whenthe clinician applies a distal force to the clip cartridge 70270 todisengage the first and second inwardly extending detents 70264 a and70264 b of the elongate shaft 70260 from the first slot and the secondslot 70274 b of the clip cartridge 70270.

Referring primarily to FIGS. 42A and 42B, the end effector 70280comprises a first jaw 70280 a and a second jaw 70280 b configured tomove relative to each other between an open position (FIG. 42A) and aclosed position (FIG. 42B). To this end, the first jaw 70280 a and thesecond jaw 70280 b comprise openings at the proximal end thereof whichare configured to receive a pin 70290. The pin 70290 is rotatablycaptured within an opening 70276 in the clip cartridge 70270. The pin70290 defines a pin axis PA which is orthogonal to the shaft axis SA.The first jaw 70280 a and the second jaw 70280 b are rotatable relativeto each other about the pin axis PA. When the first jaw 70280 a and thesecond jaw 70280 b are in the open position (FIG. 42A) a clip can bepositioned between the first jaw 70280 a and the second jaw 70280 b. Asthe first jaw 70280 a and the second jaw 70280 b are r towards theclosed position (FIG. 42B) the clip is crimped between the first jaw70280 a and the second jaw 70280 b. The first jaw 70280 a and the secondjaw 70280 b are moved from the open position to the closed position by aclosure tube which cammingly engages the outer surfaces of the first jaw70280 a and the second jaw 70280 b as the closure tube moves distally.When the closure tube is retracted, the first jaw 70280 a and the secondjaw 70280 b are returned to the open position by a biasing member, orspring, which biases the first jaw 70280 a and the second jaw 70280 binto the open position. Other embodiments are envisioned where the firstjaw 70280 a and the second jaw 70280 b are movable from the closedposition to the open position by jaw cams on the first jaw 70280 a andthe second jaw 70280 b interacting with the closure tube, similar to jawcams 70124 a and 70124 b depicted in FIGS. 36-38, for example.

FIG. 43A depicts a clip applier 70300 in accordance with at least oneembodiment. The clip applier 70300 comprises a shaft 70310, an endeffector 70320 extending from the shaft 70310, a firing drive, and aclip magazine 70306. The clip magazine 70306 is built into the shaft70310 of the clip applier 70300 as depicted in FIG. 43A. However, otherembodiments are envisioned where the clip magazine 70306 is releasablyattachable to the clip applier 70300. The shaft 70310 comprises openings70308 on either side of the shaft 70310 which allow a user of the clipapplier 70300 to access the clip magazine 70306. Other embodiments areenvisioned with only one opening in the shaft 70310 of the clip applier.The clip applier 70300 further comprises an outer tube 70302 that isslidable along the shaft 70310 of the clip applier 70300. The outer tube70302 is configured to slide along the shaft 70310 to cover the openings70308 in the shaft 70310. The clip magazine 70306 is configured to storea plurality of clips, such as clips 70304 therein. The clips 70304 areinsertable into the clip magazine 70306 through the openings 70308 whenthe outer tube 70302 is not obstructing the openings 70308, as depictedin FIG. 43A. Once positioned in the clip magazine 70306, the clips 70304can be advanced out of the clip magazine 70306 into the end effector70320 by the firing member. In at least one embodiment, the clips 70304can be sequentially advanced out of the clip magazine 70306 into the endeffector 70320. When the outer tube 70302 is covering the openings70308, access to the clip magazine 70306 is prevented, and, if clips70304 have already been inserted into the clip magazine 70306, the outertube 70302 prevents the clips 70304 from exiting the clip magazine 70306through the openings 70308. Once all of the clips 70304 inside the clipmagazine 70306 have been advanced into the end effector 70320, the outertube 70302 can be retracted to allow a new set of clips to be insertedinto the clip magazine 70306. Further to the above, the outer tube 70302can be operably engaged with the firing member of the clip applier70300, such that, when the outer tube 70302 is retracted as depicted inFIG. 43A, or at least partially retracted, the firing member cannot beactuated.

FIG. 44 depicts a clip applier 70300′. Clip applier 70300′ is similar toclip applier 70300 in many respects. The clip applier 70300′ comprisesan elongate shaft 70315 extending from a housing, an articulation joint70314 extending from the elongate shaft 70315, a shaft assembly 70310′extending from the articulation joint 70314, an end effector 70320extending from the shaft assembly 70310′, and an outer tube 70302′positioned around the shaft assembly 70310′. The articulation joint70314 connects the elongate shaft 70315 to the shaft assembly 70310′ sothat the shaft assembly 70310′ can be articulated relative to theelongate shaft 70315. The shaft assembly 70310′ comprises a proximalshaft portion 70311 extending from the articulation joint 70314, adistal shaft portion 70312 extending from the proximal shaft portion70311, and a hinge 70307. The distal shaft portion 70312 furthercomprises a clip magazine 70306′. Other embodiments are envisioned wherethe proximal shaft portion 70311 comprises the clip magazine 70306′. Thehinge 70307 allows the distal shaft portion 70312 to rotate away fromthe proximal shaft portion 70311. The outer tube 70302′ is configured toslide along the shaft assembly 70310′ between a locked position and anunlocked position when the proximal shaft portion 70311 and distal shaftportion 70312 are aligned. More specifically, when the proximal shaftportion 70311 and distal shaft portion 70312 are aligned and the outertube 70302′ is in the locked position, the distal shaft portion 70312 isprevented from rotating away from the proximal shaft portion 70311 aboutthe hinge 70307. When the outer tube 70302′ is in the unlocked position,the distal shaft portion 70312 is capable of rotating away from theproximal shaft portion 70311 about the hinge 70307. Further to theabove, when the distal shaft portion 70312 is rotated away from theproximal shaft portion 70311, an opening 70308′ in the clip magazine70306′ is exposed. The opening 70308′ allows clips 70304′ to be insertedinto the clip magazine 70306′.

Further to the above, a clip reloader 70350 can be utilized to insertthe clips 70304′ into the clip applier 70300′ as depicted in FIG. 44.The clip reloader comprises a housing 70352, a trigger 70354 movablerelative to the housing 70352, a feeder bar operably engaged with thetrigger 70354, an elongate shaft 70356 extending from the housing 70352,and a docking station 70360 extending from the elongate shaft 70356. Aplurality of clips 70304′ are removably stored in the elongate shaft70356. In one embodiment, the elongate shaft 70356 stores 20 clipswithin a six inch span of the elongate shaft 70356. Other embodimentsare envisioned with different numbers of clips and spans, for example.The clips 70304′ are advanced from the elongate shaft 70356 into thedocking station 70360 by the feeder bar when the trigger 70354 is movedtowards the housing 70352. The docking station 70360 comprises a cavity70358 configured to dock with the shaft assembly 70310′ of the clipapplier 70300′ when the distal shaft portion 70312 is rotated away fromthe proximal shaft portion 70311. When the docking station 70360 isdocked with the shaft assembly 70310′ of the clip applier 70300′, theclips 70304′ can be advanced form the elongate shaft 70356 into the clipmagazine 70306′ of the clip applier.

FIGS. 45-47 depict a different clip reloader 70400. The clip reloader70400 is similar to the clip reloader 70350 in many respects. The clipreloader 70400 comprises a housing 70410, a plurality of clips 70404stored inside the housing 70410, and a plunger 70402. The plunger 70402extends into and is movable relative to the housing 70410. The clips70404 are stacked vertically in the embodiment illustrated in FIGS. 45and 46; however, other embodiments are envisioned where the clips arestacked horizontally. A feeder block 70406 extends from the plunger70402 and is slidably engaged with the inside of the housing 70410. Thefeeder block 70406 comprises angled portions that support the backsideof the top-most clip in the clip stack as depicted in FIG. 45. Thehousing 70410 comprises a boss 70408 extending from the bottom of thehousing 70410, and a flexible ramp 70409 extending from the bottom ofthe boss 70408. The housing 70410 further comprises a cutout region70411. Docking the clip reloader 70400 with a clip applier is discussedin further detail below.

In various circumstances, the clip reloader 70400 is configured toinsert the clips 70404 into a clip applier, such as clip applier 70450,for example. The clip applier 70450 comprises a shaft 70460, an endeffector 70480 extending distally from the shaft 70460, and anarticulation joint 70470 extending proximally from the shaft 70460. Toalign the clip reloader 70400 with the clip applier 70450, the boss70408 docks with an opening 70464 in the shaft 70460 of the clip applier70450, the cutout region 70411 mates with the exterior of the shaft70460, and the flexible ramp 70409 extends into a clip slot 70462 of theclip applier 70450 as depicted in FIG. 47. The opening 70464 leads tothe clip slot 70462 which comprises an angled portion that receives theboss 70408 and flexible ramp 70409 of the clip reloader 70400. The clipslot 70462 further comprises a flat portion that facilitates theadvancement of the clips 70404 into the end effector 70480 of the clipapplier 70450. The operation of the clip reloader 70400 in conjunctionwith the clip applier 70450 is discussed in further detail below.

In use, after the clip reloader 70400 is docked with the clip applier70450, the plunger 70402 is moved towards the clip applier 70450 toadvance the clips 70404 from the housing 70410 into the angled portionof the clip slot 70462. The ramp 70409 supports and guides the clips70404 from the angled portion of the clip slot 70462 into the flatportion of the clip slot 70462. As illustrated in FIG. 47, the housing70410 of the clip reloader 70400 is positioned at an angle relative tothe longitudinal axis of the clip applier 70450 when the clip reloader70400 is docked with the clip applier 70450. Other embodiments areenvisioned where the housing 70410 is orthogonal, or at leastsubstantially orthogonal, to the clip applier 70450 when docked.Referring primarily to FIG. 47, the clip applier 70450 further comprisesa flexible firing member 70465 positioned within a firing slot 70466located proximal to the clip slot 70462. After the clip reloader 70400is un-docked with the clip applier 70450, the flexible firing member70465 can move from the firing slot 70466 into the clip slot 70462 toadvance the clips 70404 into the end effector 70480. Once at least one,or all, of the clips 70404 have been advanced into the end effector70480, the flexible firing member 70465 can be retracted from the clipslot 70462 into the firing slot 70466 and additional clips 70404 can beloaded into the clip slot 70462 by the clip reloader 70400.

FIGS. 48-50 depict a clip applier 70500. The clip applier 70500comprises an elongate shaft 70570 (see FIG. 50) extending from ahousing, a shaft 70510 attachable to the elongate shaft 70570, an endeffector 70520 extending from the shaft 70510, and a clip magazine70530. The attachable shaft 70510 comprises an upper pivot link 70512and a lower pivot link 70514 extending distally therefrom. The endeffector 70520 comprises a first jaw 70521 a and a second jaw 70521 bmovable relative to each other between an open position and a closedposition about a pivot pin 70511. The pivot pin 70511 is constrainedwithin openings in the upper pivot link 70512 and the lower pivot link70514 of the shaft 70510. The clip magazine 70530 is removablypositioned within the attachable shaft 70510 and comprises a pluralityof clips 70532. The clip applier 70500 further comprises a closuresystem 70540 and a firing system 70550. The closure system 70540 and thefiring system 70550 are discussed in greater detail below.

The closure system 70540 comprises a proximal closure driver 70542comprising a threaded portion 70543, a distal closure driver 70566comprising a closure nut 70544, an upper closure hinge 70545 a, and alower closure hinge 70545 b. The proximal closure drive 70542 isconfigured to rotate in response to rotary motions generated inside thehousing of the clip applier. The closure drive 70542 transmitsrotational motion to the threaded portion 70543 which is threadablyreceived in the closure nut 70544. The closure drive 70542 can comprisea flexible portion to facilitate the transfer of rotational motion tothe closure nut 70544. The closure nut 70544 is rotatably constrainedwithin the shaft 70510 such that rotation of the threaded portion 70543in a first direction will result in translation of the nut 70544distally, and rotation of the threaded portion 70543 in a seconddirection—opposite the first direction—will result in translation of thenut 70544 proximally. The distal closure driver 70566 extends from theclosure nut 70544 and attaches to the upper closure hinge 70545 a andthe lower closure hinge 70545 b via a closure pin 70547. The closure pin70547 allows the upper and lower closure hinges 70545 a and 70545 b totranslate distally and proximally with the distal closure driver 70566while still being rotatable about the closure pin 70547. Further to theabove, the upper closure hinge 70545 a is rotatably engaged with aproximal portion 70523 a of the first jaw 70521 a, and the lower closurehinge 70545 b is rotatably engaged with a proximal portion 70523 b ofthe second jaw 70521 b. As illustrated in FIG. 48, the first jaw 70521 aand the second jaw 70521 b cross over each other about the pivot pin70511 in a scissor like formation. Such an arrangement allows the firstjaw 70521 a and the second jaw 70521 b to move toward the open positionwhen the upper and lower closure hinges 70545 a and 70545 b aretranslated distally by the closure system 70540, and allows the firstjaw 70521 a and the second jaw 70521 b to move toward the closedposition when the upper and lower closure hinges 70545 a and 70545 b aretranslated proximally by the closure system 70540.

The clip applier 70500 further comprises a firing system 70550comprising a firing member 70560. The firing member 70560 istranslatable through the end effector between an unfired position and afired position in response to the rotary motions that drive the closuresystem 70540. Other embodiments are envisioned where the closure system70540 and the firing system 70550 are operated by two separate motorswithin the housing of the clip applier, for instance. The firing member70560 is configured to advance a clip 70532 from the clip magazine 70530into the first and second jaws 70521 a and 70521 b of the clip applier70500. As illustrated in FIG. 49, the clip magazine 70530 is at leastpartially supported by the closure system 70540. More specifically, abiasing member, such as leaf spring 70546, for example, biases the clips70532 toward the firing member 70560 and holds the clip magazine 70530in position. Other embodiments are envisioned where the closure system70540 can align, and/or guide, and/or lock the clip magazine 70530 intoplace within the shaft 70510. The embodiment depicted in FIGS. 48 and 49illustrates the closure system 70540 arranged around the clip magazine70530 to allow a larger space inside the shaft 70510 for the clipmagazine 70530 and clips 70532; however, a closure system can have anysuitable arrangement. The closure system 70540 is discussed in furtherdetail below.

The threaded portion 70543 and closure nut 70544 of the closure system70540 allows for a more precise actuation of the first and second jaws70521 a and 70521 b when moving between the open position and the closedposition as compared to previous clip applier arrangements that utilizea translating closure tube or cam member. Rotary encoders and/or othersensors can be used in combination with the closure system 70540 toprovide even greater accuracy in determining the position of the firstand second jaws 70521 a and 70521 b.

Turning now to FIG. 50, the clip applier 70500 further compriseprotrusions 70513 and 70516 extending from the proximal end of the shaft70510. The protrusions 70513 and 70516 may be the same shape ordifferent shapes. The protrusions 70513 and 70516 are configured tolockingly engage slots 70572 a and 70572 b in the elongate shaft 70570of the clip applier 70500 to form a bayonet connection therebetween. Theslots 70572 a and 70572 b comprise L-shaped portions that lock theprotrusions 70513 and 70516 into place when the shaft 70510 is insertedinto and then rotated relative to the elongate shaft 70570. FIG. 50further depicts a clip 70532 located within the first jaw 70521 a andthe second jaw 70521 b. The clip 70532 and other embodiments of clipsfor use with a clip applier, such as clip applier 70500, are discussedin further detail below.

Turning now to FIGS. 51A and 51B, the clip 70532 comprises a baseportion 70534, a first leg 70534 a extending from the base portion70534, and a second leg 70534 b extending from the base portion 70534and opposing the first leg 70534 a. The base portion 70534 can comprisea flexible material, such as plastic and/or any other suitable flexiblematerial, to allow the clip 70532 to flex between multiple positionswithout breaking or becoming plastically deformed in an unsuitablemanner. For example, the clip 70532 can be moved between a magazinestorage configuration, a pre-firing configuration, and a post-firingconfiguration as depicted in FIG. 51B. The first leg 70534 a comprises areinforced region comprising a ridge 70535 a, and the second leg 70534 bcomprises a reinforced region comprising a ridge 70535 b. The ridges70535 a and 70535 b extend along at least a portion of the first leg70534 a and the second leg 70534 b, respectively. The ridges 70535 a and70535 b act as a rigid backbone to prevent, or at least substantiallyreduce, the deformation of the first leg 70534 a and the second leg70534 b during crimping. Other embodiments are envisioned where only oneof the first leg 70534 a and the second leg 70534 b comprises a ridge.The ridges 70535 a and/or 70535 b may be comprised of a rigid material,such as a fiberglass-filled and/or particle-filled plastic, for example,to prevent, or at least reduce, deflection of the first leg 70534 aand/or the second leg 70534 b when the clip 70532 is crimped. The clip70532 further comprises a locking portion, such as tooth 70536, forexample, extending from a portion of the first leg 70534 a. The tooth70536 lockingly engages the edges of an opening, or window, 70537 in thesecond leg 70534 b when the clip 70532 is crimped (see the post-firingconfiguration in FIG. 51B). Such an arrangement allows the clip 70532 tostay in a crimped state after the clip 70532 has been released from thejaws of a clip applier. Further, the clip 70532 includes grip features,such as protrusions 70538, extending from the inside surfaces of thefirst and second legs 70534 a and 70534 b. The protrusions 70538 engagetissue clamped between the first and second legs 70534 a and 70534 bwhen the clip 70532 is crimped. The protrusions 70538 prevent, or atleast substantially reduce, the movement of the tissue relative to theclip 70532 after the clip 70532 is crimped around the tissue. Theprotrusions 70538 may be any number of shapes and sizes, such aspyramidal shapes, conical shapes, frustoconical shapes, for example,and/or any other suitable shape.

Turning now to FIGS. 51C-51F, a different clip 70580 for use with a clipapplier is depicted. The clip 70580 is similar to clip 70532 in manyrespects. That said, the base 70534 of the clip 70580 comprises a stressrelief notch 70588 on the side of the base 70534 opposite the first andsecond legs 70534 a and 70534 b. In use, the stress relief notch 70588allows the first and second legs 70534 a and 70534 b to flex inwardlyand then outwardly a number of times without being plastically deformedin an unsuitable manner. However, in various circumstances, the clip70580 can be configured to yield, or deform plastically, when the clip70580 is sufficiently compressed. Such designed or controlled yielding,in various instances, can help the clip 70580 fold into the desiredshape.

FIGS. 52-60 depict a clip applier 70600. Turning now to FIG. 53, theclip applier 70600 comprises a shaft 70610 extending from a housing, anend effector 70605 extending from the shaft 70610, and a rotatable clipmagazine 70650. The end effector 70605 comprises a first jaw and asecond jaw that are movable relative to each other between an openposition and a closed position, similar to the first jaw 70123 a and thesecond jaw 70123 b of the clip applier 70100 discussed above. Therotatable clip magazine 70650 is rotatably and slidably supported withinthe clip applier 70600. More specifically, the rotatable clip magazine70650 is rotatable about shaft axis SA and translatable along shaft axisSA. The shaft axis SA is defined by the shaft 70610. Further detailregarding how the clip magazine 70650 is supported within the clipapplier 70600 is provided below.

Referring to FIG. 52, the rotatable clip magazine 70650 comprises a bodyportion 70652 including five sides, each of which comprises a clipchannel 70656 configured to removably store a clip 70654 therein. Thebody portion 70652 further comprises an opening 70653 that extendsthrough the body portion 70652. In the illustrated embodiment, the bodyportion 70652 is pentagonal in shape, for example; however, otherembodiments are envisioned in which the opening 70653 comprisesdifferent shapes to allow for more than or less than five clip channels70656 and, therefore, more than or less than five clips 70654 stored inthe rotatable clip magazine 70650. In at least one embodiment, the clips70654 comprise a clip width of 0.080″, a clip thickness of 0.03″, and aclip length of 0.310″ (for a Lig 5 Clip) or 0.315″ (for an ER320 Clip),for example; however, clips having any suitable size can be used.Moreover, it is envisioned that the clips stored in the clip magazine70650 will have the same, or at least substantially the same size;however, alternative embodiments are envisioned in which clips havingdifferent sizes may be stored in the same clip magazine. Further, in atleast one embodiment, the overall diameter of the entire rotatable clipmagazine 70650 is 0.996″, for example; however, the clip magazine 70650can have any suitable diameter—including diameters which can permit theclip magazine 70650 to be inserted through a trocar. The rotatable clipmagazine 70650 further includes a clocking portion, such as teeth 70658,for example, extending proximally from the clip magazine 70650. The clipapplier 70600 comprises several drives and drivers which define themotion and/or operating sequence of the clip applier 70600, as describedin further detail below.

Referring again to FIG. 53, the clip applier 70600 further comprises aclosure tube 70620, a feeder member 70630, and a firing member 70640.The closure tube 70620 comprises a closure drive 70625 extendingproximally from the closure tube 70620. The closure drive 70625 extendsthrough the opening 70653 in the clip magazine 70650 and is operablyengaged with an actuator inside the housing of the clip applier 70600.The clip magazine 70650 is supported on at least a portion of theclosure drive 70625. The closure tube 70620 is at least partiallysupported and aligned within a recess in the shaft 70610. The closuretube 70620 is movable between a plurality of positions, such as a fullyretracted position, a home position, and a fully advanced position (seeFIGS. 53 and 54A). Similar to the crimping drive 70180 of the clipapplier 70100, the closure tube 70620 is configured to move the firstjaw and the second jaw of the end effector 70605 toward and away fromeach other. When the closure tube 70620 moves distally, the closure tube70620 cammingly engages the first and second jaws to move the first andsecond jaws to the closed position and, when the closure tube 70620moves proximally, the closure tube 70620 engages jaw cams on each of thefirst and second jaws to move the first and second jaws to the openposition. That said, any suitable jaw opening and closing arrangementcould be used.

The feeder member 70630 is aligned with one of the clip channels 70656of the rotatable clip cartridge 70650, and is configured to advance aclip 70654 out of the clip channel 70656 that is aligned with the feedermember 70630 toward the end effector 70605. The feeder member 70630 istranslatable linearly through the clip applier 70600 by a feeder gear70638 and a feeder drive 70635 which are operably engaged with a rackportion of the feeder member 70630. The feeder drive 70635 comprises apinion gear 70637 at the distal end thereof which is operably engagedwith the feeder gear 70638 such that, as the feeder drive 70635 isrotated, the feeder member 70630 is translated linearly through the clipapplier 70600. The feeder drive 70635 is operably engaged with a firstmotor inside the housing of the clip applier 70600. The first motortransmits rotational motion to the feeder drive 70635. Similar to theoperation of the feeder member 70630, the firing member 70640 istranslatable linearly through the clip applier by a firing gear 70648and a firing drive 70645 which are operably engaged with a rack portionof the firing member 70640. The firing drive 70645 comprises a piniongear 70647 on the distal end thereof which is engaged with the firinggear 70648 such that, as the firing drive 70645 is rotated, the firingmember 70640 is translated linearly through the clip applier 70600.Further, the firing drive 70645 is operably engaged with a second motorinside the housing of the clip applier 70600. The second motor transmitsrotational motion to the firing drive 70645. Other embodiments areenvisioned where the feeder drive 70635 and the firing drive 70645 arerotatable by the same motor utilizing a transmission. Further, otherembodiments are envisioned, and are described further below, where thefeeder member 70630 and the firing member 70640 translate togetherthrough the clip applier 70600. Operation of the feeder member 70630 andfiring member 70640 are also described in greater detail below.

Referring primarily to FIG. 53, the firing member 70640 comprises adistal portion 70640 a extending therefrom that is configured to advancea clip 70654 into the end effector. The shaft 70610 further includes aground portion 70612 mounted to the shaft 70610 and aligned with theclip magazine 70650. The ground portion 70612 is mounted to the shaft70610 such that the ground portion 70612 is not movable, translatable,and/or rotatable relative to the shaft 70610. The ground portion 70612includes a clocking portion, such as teeth 70614, for example, extendingdistally therefrom as illustrated in FIG. 54B. The teeth 70614 of theground portion 70612 are aligned, or at least substantially aligned,with the teeth 70658 of the rotatable clip magazine 70650. Further, theground portion 70612 supports a biasing member, such as spring 70616,for example, thereon. The spring 70616 biases the clip magazine 70650distally toward the closure tube 70620 and the end effector 70605, asillustrated in FIG. 54A. Other embodiments are envisioned where thespring comprises a leaf spring and the clip applier 70600 furthercomprises a track and the leaf spring can be configured to both indexthe clip magazine 70650 and prevent the clip magazine 70650 from counterrotation. In any event, the rotation of the clip magazine 70650 aboutthe shaft axis SA and translation of the clip magazine 70650 along shaftaxis SA is described in further detail below.

Referring primarily to FIG. 52, the closure tube 70620 includes clockingchannels 70622 located radially around the closure drive 70625. Theclosure drive 70625 rotatably and slidably supports the rotatable clipmagazine 70650 thereon as discussed above. The clocking channels 70622are engaged with protrusions within the opening 70653 of the clipmagazine 70650 to rotatingly lock the clip magazine 70650 into placerelative to the closure tube 70620 when the closure tube is in the homeposition or the fully advanced position. When the closure tube 70620 ismoved to the fully retracted position, as illustrated in FIG. 53, thespring 70616 moves/biases the clip magazine 70650 toward the closuretube 70620 resulting in the clocking channels 70622 becoming disengagedfrom the protrusions within the opening 70653 of the clip magazine70650. As such, the clip magazine 70650 can rotate freely about shaftaxis SA. Further, when the closure tube 70620 is moved to the fullyretracted position, the teeth 70658 of the clip magazine 70650 engagethe teeth 70614 of the ground portion 70612 to rotate (i.e., cycle) theclip magazine 70650. More specifically, the teeth 70658 and the teeth70614 are structured to rotate the clip magazine 70650 about the shaftaxis SA a predefined amount of degrees based on the spacing and anglesof the teeth 70658 relative to the teeth 70614. The reader willappreciate that the spacing and angles of the teeth 70658 relative tothe teeth 70614 can be designed to generate a suitable degree ofrotation for the clip magazine 70650 about shaft axis SA. In theembodiment depicted in FIGS. 52-54A, the teeth 70658 and the teeth 70614are spaced and aligned such that, when they are engaged, the clipmagazine 70650 rotates 72 degrees to align an adjacent clip 70654 withthe feeder member 70630. After the clip magazine 70650 is cycled, theclosure tube 70620 can be moved distally from the fully retractedposition to the home position (FIG. 54A) resulting in the clockingchannels 70622 engaging the protrusions in the opening 70653 of the clipmagazine 70650 to lock the rotation of the clip magazine 70650 asdiscussed above. Usage of the clip applier 70600 to advance, form, andfire a clip 70654 is describe in further detail below.

As mentioned above, the feeder member 70630 and firing member 70640 canbe translatable together. For simplicity, FIGS. 55-60 illustrate thefunctions of clip applier 70600 where the feeder member 70630 and firingmember 70640 move together to feed and fire a clip 70654 from therotatable clip magazine 70650. Turning now to FIGS. 55 and 56, a clip70654 is advanced from the rotatable clip magazine 70650 into engagementwith a biasing member, such as a leaf spring 70624, for example, of theclosure tube 70620 by the feeder member 70630. The leaf spring 70624biases and guides the clip 70654 onto the top of the firing member70640, as illustrated in FIG. 56. When the firing member 70640 andfeeder member 70630 are retracted, the clip 70654 is moved furtherdownward by the leaf spring 70624 and seated around pre-form features,such as protrusions 70608, for example, depicted in FIG. 57. Protrusions70608 can be similar to protrusions 70126 a and 70126 b described above(See FIGS. 35A and 35B). One protrusion 70608 is located on one jaw ofthe end effector 70605, and another protrusion 70608 is located onanother jaw of the end effector 70605.

When the closure tube 70620 is in the fully retracted position,referring to FIG. 58, the jaws of the clip applier 70600 are in the openposition and the protrusions 70608 expand the clip 70654 from a storageconfiguration into a firing configuration—similar to the expansion ofclip 70140 described above in connection with FIGS. 35A and 35B. Whenthe closure tube 70620 is moved to the fully retracted position, asdescribed above, the rotatable clip magazine 70650 is rotated (i.e.,cycled) about the shaft axis SA to position another clip 70654 intoalignment with the feeder member 70630. Turning to FIG. 59, the firingmember 70640 can be moved toward the end effector 70605 to advance theclip 70654 over the protrusions 70608 and into the end effector 70605.As discussed above in connection with protrusions 70126 a and 70126 b,the protrusions 70608 can comprise angled portions that allow the clip70654 to slide over the protrusions 70608 when advanced distally by thefiring member 70640. Once the clip 70654 is positioned in the endeffector 70605, the closure tube 70620 can be moved to the fullyadvanced position (FIG. 60) to move the jaws from the open position tothe closed position to crimp the clip 70654 positioned between the jaws.

Because the feeder member 70630 and the firing member 70640 translatetogether, further to the above, the feeder member 70630 advances anotherclip 70654 (i.e., the clip that was rotated into position when theclosure tube 70620 was fully retracted) from the clip cartridge 70650down onto the firing member 70654 with the aid of the leaf spring 70624,as discussed above, when the firing member 70640 advances a clip 70654into the end effector 70605. Again, the firing member 70640 and thefeeder member 70630 can be retracted to allow the new clip 70654 to bebiased downward by the leaf spring 70624 and seated around theprotrusions 70608. The new clip 70654 can then be expanded to the firingconfiguration as clip magazine 70650 is cycled, and then the new clip70654 can be advanced into the end effector 70605 for crimping asdiscussed above. The process discussed above can be repeated until theclip magazine 70650 has been spent. The reader will appreciate that theclosure tube 70620 can be moved between the home position (FIGS. 56 and57) and the fully advanced position (FIG. 60) to crimp and release aclip 70654 within the end effector 70605 without cycling the clipmagazine 70650. This allows the jaws of the end effector 70605 to movebetween the open and closed positions without cycling the clip magazine70650 and/or ejecting another clip from the clip magazine 70650.

FIG. 61 depicts a clip applier 70700 in accordance with at least oneembodiment. The clip applier 70700 comprises a shaft 70710 extendingfrom a housing, an end effector 70705 extending from the shaft 70710,and a clip cartridge 70720 that is releasably attachable to the clipapplier 70700. The end effector 70705 comprises a first jaw and a secondjaw movable relative to each other, similar to the first and second jaws70123 a and 70123 b discussed above. The clip applier 70700 furthercomprises a firing system 70730 that comprises a rotatable drive 70732which is operably responsive to a motor inside the housing of the clipapplier 70700. The rotatable drive 70732 comprises a threaded portion.The firing system 70730 further includes a firing member 70736 and afiring nut 70734. The firing nut 70734 is threadably received on thethreaded portion of the rotatable drive 70732. The firing nut 70734 isrotatably constrained within the clip applier 70700 such that therotation of the rotatable drive 70732 translates the firing nut 70734through the clip applier 70700. The firing member 70736 is engaged withthe firing nut 70734 and translates into the first and second jaws ofthe end effector 70705 in response to translation of the firing nut70734 by the rotatable drive 70732. Attachment of the clip cartridge70720 to the clip applier 70700 is described in greater detail below.

The clip applier 70700 further comprises a docking region, or recess70714, in the distal end of the clip applier 70700, as illustrated inFIG. 61. The clip cartridge 70720 comprises a body portion 70722 that isslidably receivable in the recess 70714 of the clip applier 70700. Alocking feature 70728 extends proximally from the clip cartridge 70720.The locking feature 70728 includes an angled surface 70728 a at theproximal end thereof and a detent 70728 b extending downwardly, althoughthe locking feature 70728 can include any suitable arrangement. Thelocking feature 70728 engages a protrusion 70712 of the shaft 70710 whenthe clip cartridge 70720 is docked within the recess 70714. Morespecifically, the angled surface 70728 a slides over the protrusion70712 and the downwardly extending detent 70728 b locks into placeproximal to the protrusion 70712, thus locking the clip cartridge 70720to the clip applier 70700. In such instances, the locking feature 70728deflects as the angled surface 70728 a slides over the protrusion 70712and then resiliently returns to, or at least toward, its undeflectedconfiguration, when the detent 70728 b locks into place. A sufficientdistal pulling motion can cause the locking feature 70728 to deflect andrelease the clip cartridge 70720 from the clip applier 70700. Operationof the clip applier 70700 is described in further detail below.

The clip cartridge 70720 further comprises a ramp portion 70721, aplurality of clips 70724 positioned in a stack, and biasing members,such as springs 70726, for example. The clips 70724 are biased towardthe ramp portion 70721 by the springs 70726. In fact, the top clip 70724in the stack of clips is biased into the ramp portion 70712 by thesprings 70726. When the clip cartridge 70720 is docked with the clipapplier 70700, as discussed above, the ramp portion 70721 aligns with afeeder drive 70740 of the clip applier 70700. The feeder drive 70740 isoperably responsive to an actuator within the housing of the clipapplier 70700. The feeder drive 70740 is configured to reciprocatinglyactuate into the ramp portion 70721. To accommodate an angled portionwithin the ramp portion 70721 the feeder drive 70740 can be flexible.The feeder drive 70740 feeds the top clip 70724 in the stack of clipsthrough the ramp portion 70721 and into the end effector 70720. Once inthe end effector 70705, the clip 70724 can be advanced further distallyinto the first and second jaws of the end effector 70705 by translationof the firing member 70736, as discussed above. Once located in thefirst and second jaws, the clip 70724 can be crimped by a crimpingdrive. The feeder drive 70740 can be retracted, allowing another clip70724 to be biased into the ramp portion 70721. The feeder drive 70740can advance the new clip 70724 through the ramp portion 70721 and intothe first and second jaws of the end effector 70705 as discussed above.The process discussed above can be repeated until all of the clips 70724in the clip cartridge 70720 have been depleted, and/or until a suitablenumber of clips have been applied to the tissue.

FIG. 62A depicts a clip applier system 70750 in accordance with at leastone embodiment. The clip applier system 70750 comprises a shaft 70760extending from a housing, the clip applier 70250 depicted in FIG. 42positioned at least partially within the shaft 70760, and the rotatableclip magazine 70650 depicted in FIGS. 52-60 positioned within the shaft70760. A feeder member is configured to advance the clips 70654 from therotatable clip magazine 70650—one at a time—into the first and secondjaws 70280 a and 70280 b of the clip applier 70250. Once located withinthe first and second jaws 70280 a and 70280 b, the clip 70654 can becrimped as discussed above in relation to FIGS. 42A and 42B. Once theclip 70654 is crimped, the rotatable clip magazine 70650 can be cycled(i.e., rotated) to position another clip 70654 for advancement into thefirst and second jaws 70280 a and 70280 b of the clip applier 70250 bythe feeder member. This process can continue until all of the clips70654 in the rotatable clip magazine 70650 have been spent. After all ofthe clips 70654 have been spent, the rotatable clip magazine 70650 canbe replaced with another rotatable clip magazine 70650 containing a fullcomplement of clips 70650. Other embodiments are envisioned where thespent rotatable clip magazine 70650 can be detached from the clipapplier system 70750, reloaded with clips 70650, and then re-attached tothe clip applier system 70750 for further use.

Turning now to FIGS. 63A and 63B, an articulation joint 70800 for usewith a clip applier is illustrated. The articulation joint 70800releasably couples a clip cartridge 70820 to a shaft 70810 of a clipapplier. The shaft 70810 comprises an articulation pivot, or pivot pin70814, extending from the inside of the shaft 70810. The pivot pin 70814comprises a base portion 70817, a first leg 70814 a extending from thebase portion 70817, and a second leg 70814 b extending from the baseportion 70817 and opposing the first leg 70814 a. The first and secondlegs 70814 a and 70814 b extend away from each other. The first leg70814 a comprises a first detent, or shoulder, 70816 a extendingoutwardly from the first leg 70814 a, and the second leg 70814 bcomprises a second detent, or shoulder, 70816 b extending outwardly fromthe second leg 70814 b. The clip cartridge 70820 comprises a firstopening 70822 and, also, a second opening 70824 positioned adjacent andlateral to the first opening 70822. The first opening 70822 is centeredin the clip cartridge 70820 and rotatably receives the pivot pin 70814when the clip cartridge 70820 is attached to the shaft 70810. The firstleg 70814 a and the second leg 70814 b flex towards each other when thefirst opening 70822 is slid onto the pivot pin 70814 due to angledsurfaces at the end of each of the first leg 70814 a and second leg70814 b (See FIG. 63B). As the first leg 70814 a and second leg 70814 bflex toward each other, the pivot pin 70814 can slide through the firstopening 70822 until the first and second detents 70816 a and 70816 bclear the first opening 70822, as illustrated in FIG. 63B. Once thefirst and second detents 70816 a and 70816 b clear the first opening70822, the first and second legs 70814 a and 70814 b can expand to lockthe clip cartridge 70820 to the pivot pin 70814. More specifically, thebottom surfaces of the first and second detents 70816 a and 70816 b reston an outer surface 70826 of the clip cartridge 70822 preventing theclip cartridge 70820 from being detached from the pivot pin 70814 unlessa sufficient force is applied that exceeds a predetermined, or designed,force threshold. The reader will appreciate that, with force, a user ofthe clip applier can attach and detach the clip cartridge 70820 to theshaft 70810. Articulation of the clip cartridge about the pivot pin70814 is described in further detail below.

The clip applier depicted in FIGS. 63A and 63B further comprises arotatable output 70830 that is operably responsive to a motor locatedwithin the housing of the clip applier. The rotatable output 70830 isthreadably engaged with a threaded portion 70834 of an articulation bar70832. Rotation of the rotatably output 70830 in a first directiontranslates the articulation bar 70832 distally, and rotation of therotatable output 70830 in a second, or opposite, direction translatesthe articulation bar 70832 proximally. The articulation bar 70832comprises a downwardly extending protrusion 70836 that is slidablyreceived in a slot 70812 defined in the shaft 70810. The protrusion70836 and slot 70812 guide the articulation bar 70832 as thearticulation bar 70832 translates and limit relative lateral motionbetween the articulation bar 70832 and the shaft 70810. The articulationbar 70832 further comprises an upwardly extending protrusion 70838 whichis received in the second opening 70824 of the clip cartridge 70820 whenthe clip cartridge 70820 is attached to the shaft 70810. In use, thedistal translation of the articulation bar 70832 will rotate the clipcartridge 70820 about the pivot pin 70814 in a first direction and theproximal translation of the articulation bar 70832 will rotate the clipcartridge 70820 about the pivot pin 70814 in a second, or opposite,direction. The articulation bar 70832 can be flexible to allow thearticulation bar 70832 to flex as needed when the clip cartridge 70820is articulated about the pivot pin 70814.

FIG. 64 depicts a clip applier 70900 in accordance with at least oneembodiment. The clip applier 70900 comprises an elongate shaft 70910, anarticulation joint 70920, and a distal head 70930. The articulationjoint 70920 extends from the elongate shaft 70910 and the distal head70930 extends from the articulation joint 70920. The distal head 70930comprises a distal shaft 70932 attached to the articulation joint 70920,an end effector 70936 including a first jaw 70936 a and a second jaw70936 b, and a clip cartridge 70934. The first jaw 70936 a and secondjaw 70936 b are movable relative to each other between open and closedpositions by any suitable drive system, such as the drive systemsdisclosed herein, for example. The clip cartridge 70934 stores aplurality of clips which can be advanced into the end effector 70936 andcrimped by the first jaw 70936 a and the second jaw 70936 b. The clipcartridge 70934 is removably attachable to the distal shaft 70932 via akeying arrangement 70938. Other embodiments are envisioned where theclip cartridge 70934 is not removably attachable to the distal shaft70932. The elongate shaft 70910 defines a first roll axis RA₁ and thedistal head 70930 defines a second roll axis RA₂. The elongate shaft70910 and the distal head 70930 are articulable relative to each otherabout articulation axis AA via the articulation joint 70920. Thearrangement depicted in FIG. 64 is attachable—via the elongate shaft70910—to a plurality of clip applier handle types, such as, a standardhandle (i.e., a wand grip) and/or a pistol grip handle, for example.Depending on the type of handle that is attached to the elongate shaft70910, different actuations of, or within, the handle may performdifferent actuations of the arrangement depicted in FIG. 64 about thefirst roll axis RA₁, the second roll axis RA₂, and the articulation axisAA. These actuations are described in further detail below.

If the elongate shaft 70910 is attached to a standard handle (i.e., awand handle), referring still to FIG. 64, the elongate shaft 70910, thearticulation joint 70920, and the distal head 70930 are all rotatableabout the first roll axis RA₁ by the clinician rotating the wand handle.Further, a rotary knob on the wand handle is operably engaged with theelongate shaft 70910, through an electric motor and/or control system,for example, such that manually rotating the rotary knob will result inthe distal head 70930 rotating about the second roll axis RA₂. Further,articulation of the distal head 70930 relative to the elongate shaft70910 about articulation axis AA is driven by an articulation driveroperably engaged with a motor housed within the wand handle, forexample. If the elongate shaft 70910 is attached to a pistol griphandle, such as the handle 700 discussed above, for example, theelongate shaft 70910, the articulation joint 70920, and the distal head70930 are all rotatable about the first roll axis RA₁ by a rotary knob,for example. Further, the distal head 70930 is rotated about the secondroll axis RA₂ by a dedicated motor within the pistol grip handle.Further still, articulation of the distal head 70930 relative to theelongate shaft 70910 about articulation axis AA is induced by anarticulation driver operably engaged with a motor housed within thepistol grip handle. The reader should appreciate that, depending on thetype of handle attached to the arrangement depicted in FIG. 64, rotationof the elongate shaft 70910 about the first roll axis RA₁ can beaccomplished by rotating the entire handle manually, rotation of arotary knob engaged with the elongated shaft, and/or by a dedicatedmotor inside the handle. Further, the rotation of the distal head 70930about the second roll axis RA₂ can be accomplished by rotation of arotary knob engaged within the elongate shaft 70910 or by a dedicatedmotor inside the handle.

A clip applier jaw assembly 70950, or half of the jaw assembly 70950,and a clip leg 70954 of a clip are illustrated in FIG. 65. As can beseen in FIG. 65, the clip applier jaw assembly 70950 comprises a firstjaw 70950 a which includes a base 70952, a first leg 70952 a extendingfrom the base 70952, and a second leg 70952 b extending from the base70952. The first leg 70952 a and second leg 70952 b oppose one anotherand define a receiving area 70953 therebetween. The clip leg 70954 isreceived in the receiving area 70953 but, notably, part of the clip leg70954 cross-section is not positioned within the receiving area 70953.Thus, only portions of the clip leg 70954 cross-section are supported bythe first jaw 70950 a. Other arrangements exist where the receiving area70953 is substantially the same depth and width as the clip leg 70954 ofthe clip such that all, or at least substantially all, of thecross-section of the clip leg 70954 is positioned within the receivingarea 70953 and supported by the first jaw 70950 a.

A clip applier jaw assembly 70960 is depicted in FIG. 66A. The clipapplier jaw assembly 70960 comprises a first jaw 70960 a which includesa base 70962, a first leg 70962 a, a second leg 70962 b, and a receivingarea 70963 which receives a first clip leg 70964 of a clip. The firstleg 70962 a of the first jaw 70960 a extends from the base portion 70962beyond the first clip leg 70964 when the first clip leg 70964 is seatedin the receiving area 70963. The second leg 70962 b of the first jaw70960 a extends from the base portion 70962 and terminates prior to theend of the first clip leg 70964 such that only a portion of the firstclip leg 70964 is supported by the second leg 70962 b of the first jaw70960 a.

The clip applier jaw assembly 70960 further comprises a second jaw 70960b positioned opposite, or opposing, the first jaw 70960 a. The secondjaw 70960 b comprises a base 70962′, a first leg 70962 a′, a second leg70962 b′, and a receiving area 70963′ which receives a second clip leg70964′ of the clip. The second jaw 70960 b opposes the first jaw 70960 asuch that the first leg 70962 a of the first jaw 70960 a is aligned withthe first leg 70962 a′ of the second jaw 70960 b, and the second leg70962 b of the first jaw 70960 a is aligned with the second leg 70962 b′of the second jaw 70960 b. The second leg 70962 b′ of the second jaw70960 b extends from the base portion 70962′ beyond the second clip leg70964′ of the clip when the second clip leg 70964′ is seated in thereceiving area 70963′. Further, the first leg 70962 a′ of the second jaw70960 b extends from the base portion 70962′ and terminates prior to theend of the second clip leg 70964′ such that only a portion of the secondclip leg 70964′ is supported by the first leg 70962 a′ of the second jaw70960 b.

When the first jaw 70962 a and the second jaw 70962 b of the clipapplier jaw assembly 70960 are in a closed configuration, as depicted inFIG. 66B, the first leg 70962 a of the first jaw 70960 a supports theentire first clip leg 70964 of the clip and, also, a portion of thesecond clip leg 70964′ of the clip. Further, the second leg 70962 b′ ofthe second jaw 70960 b supports the entire second clip leg 70964′ of theclip and, also, a portion of the first clip leg 70964 of the clip.Because the first leg 70962 a of the first jaw 70960 a and the secondleg 70962 b′ of the second jaw 70960 b are opposite one another, thecross-sections of the first clip leg 70964 and the second clip leg70964′ are supported by both the first jaw 70960 a and the second jaw70960 b—along at least a portion of the leg lengths. Such an arrangementprevents, or at least inhibits, the clip from twisting when the clip iscrimped.

Referring to FIG. 67, the clip leg 70954 is seated within the first clipjaw 70950 a of the clip applier jaw assembly 70950 but is not preventedfrom being slid longitudinally within the clip applier jaw assembly70950. In accordance with at least one embodiment, such as the clipapplier jaw assembly 70960, for example, the first jaw 70960 a and/orthe second jaw 70960 b comprise a clip ejection prevention feature, suchas distal stop 70966. The distal stop 70966 prevents the clip 70964 fromsliding out of the distal end of the first jaw 70950 a and/or the secondjaw 70950 b of the clip applier jaw assembly 70960. Other clip applierjaw shapes and guidance features configured to control the position ofthe clip, and/or prevent the unintentional dropping and/or ejection ofthe clip from the clip applier, are discussed in greater detail below.

As discussed above, the jaws of a clip applier, or “clip jaws”, are usedto deform the clips. As the reader should appreciate, the clip jawsthemselves undergo stresses and strains and, in some instances, can beplastically deformed. Clip jaws designed to resist plastic deformationduring use may comprise clip jaws which vary in thickness, width, and/orclip path depth along the clip jaw lengths in order to improve thestiffness in a lap clip applier, for example. Further, a proximalportion of one of the clip applier jaws can comprise a protruding bar(i.e., a tongue portion) and a proximal portion of the other clipapplier jaw can comprise a recess (i.e., a groove portion) such that theprotruding bar is seated in the recess when the clip applier jaws areclosed. Such an arrangement provides for superior jaw resilience tovertical skewing and/or twisting of the clip applier jaws relative toeach other during crimping of a clip. Improved clip retention structuresare discussed in further detail below.

In at least one embodiment, the clip applier jaws may comprise a clipretention channel, or recess, to allow a clip to be advanced into theclip applier jaws via a feeder member from below. The feeder memberincludes a flexible drive plate that is retracted when the clip applierjaws are actuated (i.e., moved from an open position to a closedposition) and is extended into the distal end of the clip applier jawsto hold the clip in a distal position until the clip applier jaws areactuated. Further, the feeding member prevents any further clips frominadvertently advancing into the clip applier jaws until the feedermember is retracted to retrieve and advance the next clip. Clip applierjaws including a distal retaining feature are discussed in greaterdetail below.

In at least one embodiment, the clip applier jaws each comprise a distalretaining feature, such as a ledge, for example, that extends above aguidance trough in the clip applier jaws. The guidance trough maycomprise retention features, such as recesses, for example, on thedistal end thereof which mate with protrusions on the clip to allow theclip to remain in a distal position within the clip applier jaws withoutneeding to be held into place by a firing member and/or feeder member.The construction and manufacturing of certain clip applier jaws isdiscussed in greater detail below.

In various embodiments, the clip applier jaws are manufactured using atwo part method where at least the distal portions of the clip applierjaws are metal injection molded (MIM) within an injection mold. Incertain instances, the injection mold comprises two sides which aretranslatable toward and away from each other along a parting axis andthe interface between the two mold halves is often planar, or at leastsubstantially planar, and is often called a “parting plane”. In at leastone such instance, the parting plane is perpendicular to the axis of aclip trough of the clip applier jaws formed within the injection mold.Such an arrangement allows stiffening features, such as a rail, forexample, to be designed onto the back side of the clip applier jaws,friction or holding features within the clip trough, and/or the distalholding features discussed above, for instance. Using a MIM process mayoften require the clip applier jaws to be machined, ground, and/orpolished, for example, after being removed from the injection mold. Theclip applier jaws are then either pivotally pined together and/or weldedpivotally to the connection features of an end effector. By using MIM toproduce certain portions of the jaws, the cost to produce the jaws canbe reduced as inexpensive manufacturing methods can be utilized for theconnection features, as opposed to using MIM to produce the entire clipapplier jaws. Further, the clip applier jaws can be independentlymanufactured using MIM and then welded to a spring based interconnectionclip. Moreover, independently manufactured clip applier jaws that arethereafter assembled together allows for the clip applier jaws to have ametallic clip guidance track to be built into the lateral inside facingportion of the clip applier jaws. The independently manufactured clipapplier jaws using MIM may further comprise distal clip retentionfeatures, such as ledges, for example, which prevent the unintentionalejection of a clip from the distal end of the clip applier jaws. Suchdistal clip retention features can extend above the primary face of theclip applier jaws owing to these MIM processes.

As discussed above, and as described in greater detail below, certainclip appliers are configured to be inserted into a patient through apassage defined in a trocar. That said, the clip jaws of many clipappliers are wider than the trocar passage when they are in their openconfiguration. Described below are various systems that can beincorporated into a clip applier to facilitate the insertion of the clipapplier through the trocar passage.

Referring to FIG. 69, a graph 71000 depicts the movements of a cammember and a feeder/firing member of a clip applier, such as the clipapplier 70100, for example. The cam member is similar to cam member70180 and the feeder shoe is similar to firing member 70165 illustratedin FIGS. 35A-38, for example. In order to configure the clip applier70100 in a trocar-insertion configuration, the cam member is moved to afully advanced position to close the jaws of the clip applier and thefeeder shoe is moved to a fully retracted position. In variousinstances, the clip applier comprises a control system including abutton which, when depressed, places the clip applier in itstrocar-insertion configuration. In at least one instance, the controlsystem operates the one or more electric motors of the clip applier toconfigure the drive systems as described above. At such point, the clipapplier is ready to be inserted into the patient through the trocar.Once inserted into the patient, the button can be pressed again and, inresponse thereto, the control system will retract the cam member to afully retracted position and open the jaws of the clip applier. Thisbutton can be pressed repeatedly to toggle the configuration of the clipapplier as needed. Such an arrangement is also useful to remove the clipapplier from the patient through the trocar. The reader shouldappreciate that the opening and closing of the jaws via the button willnot affect the other functions of the clip applier such as advancing aclip, forming a clip, and/or ejecting a clip from the clip magazine.

Once the clip applier has been inserted through the trocar and thebutton has been actuated a second time (i.e., the jaws are open),further to the above, a firing button can be pressed resulting in thefeeder shoe advancing to a fully advanced position. A clip will beadvanced with the feeder shoe as described above in relation to clipapplier 70100 (FIGS. 35A-38), for instance. The feeder shoe can then beretracted to a fully retracted position and the cam member can beadvanced to the fully advanced position to form the clip around tissueof the patient, as also described above. The cam member can then beretracted to the fully retracted position to release the clip and thetissue. Once all of the clips have been applied, or at least asufficient number of clips have been applied, the button could beactuated again to close the jaws to allow the clip applier to be removedthrough the trocar. Such an arrangement enables the user of the clipapplier to close the jaws without releasing a loose clip into thepatient.

Further to the above, embodiments are envisioned where a clip appliercomprises a motor and a motor controller. The motor controller can beconfigured to control the motor via a processor and a memory. The motorcontroller can implement motor control algorithms to configure the jawsto open and close as well as advance a clip into the jaws. For example,a motor control algorithm can be implemented to allow the jaws toadvance a clip into a crimping and/or forming position, as describedabove, after the jaws have been inserted through the trocar. By notfeeding a clip into the jaws until after the clip applier has beenintroduced into the patient, the jaws can be moved into a very compactarrangement when being inserted through the trocar as discussed above.

Turning now to FIG. 70, a graph 71100 depicts the movements of a cammember and a feeder shoe of a clip applier comprising a rotating clipmagazine (i.e., a barrel magazine), such as the clip applier 70600, forexample. The operation of the clip applier depicted in FIG. 70 issimilar to that of clip applier 70600 in many respects. For example, thecam member is similar to closure tube 70620, the feeder shoe is similarto feeder member 70630, and the barrel magazine is similar to rotatableclip magazine 70650 illustrated in FIGS. 52-60, for example. The clipapplier is placed into the patient through a trocar with the jaws closedand a clip positioned in the jaws and another clip aligned with thefeeder shoe for deployment out of the barrel magazine. With the feedershoe in the home position (i.e., zero displacement) the cam member canbe advanced to a fully advanced position from the home position to crimpthe clip already placed within the jaws. In at least one instance, thedistance between the home position and the fully advanced position is0.3″, for example. The cam member is then retracted to a partiallyadvanced position just proximal to the fully advanced position to reducethe force applied to the clip by the jaws. The cam member is advancedagain to the fully advanced position to crimp the clip again. Byapplying a force, reducing that force, and then applying the same, oranother, force again, the elasticity within the clip can be reduced suchthat full plastic deformation can occur to properly crimp the clip ontothe patient tissue. The partially advanced position is dependent on thetype of clip being utilized with the clip applier. For example, thepartially advanced position is preferably 0.2″ distal from the homeposition for a clip with a clip opening of 0.210″ and is preferably0.23″ distal from the home position for a clip with a clip opening of0.180″, for example. Suitable thresholds can be set by the userdepending on the type of clips in the barrel magazine being utilizedwith the clip applier. Other embodiments are envisioned with differentclip sizes and position arrangements for the partially retracted andfully advanced positions.

In any event, after the clip has been properly crimped, the cam memberis then retracted proximally toward the home position as the feeder shoedistally advances a clip out of the barrel magazine toward the jaws ofthe clip applier into a pre-form position when the feeder shoe is 0.08″distal from the home position, for example. When the clip is in thepre-form position, the jaws can be partially opened by retracting thecam member slightly beyond the home position, i.e., the cam memberinteracts with the jaws of the clip applier to open the jaws when thecam member is retracted proximal to the home position, as discussedabove. Such an arrangement allows the clip to be expanded by thepre-form features on each of the jaws (i.e., protrusions 70608) asdiscussed above. The feeder shoe then distally advances the clip furtherinto a crimping position—0.3″ distal to the home position, for example.Once the feeder shoe is advanced beyond the barrel magazine (i.e., tothe pre-form position) the barrel magazine can be cycled (i.e., rotated)to position another clip for advancement into the jaws. The barrelmagazine is cycled by retracting the cam member to a fully retractedposition—0.05″ proximal to the home position, for example. The cycledclip will be biased against the feeder shoe which prevents the clip frombeing completely ejected from the barrel magazine. Once the feeder shoeis retracted to the home position the cycled clip can be displayed(i.e., the biasing member in the barrel magazine can now position thecycled clip into alignment with the feeder shoe because the feeder shoehas been retracted and is no longer blocking such movement). At thispoint a clip that has been pre-formed is positioned in the jaws andanother clip is aligned with the feeder shoe for deployment out of thebarrel magazine into the clip applier jaws, just as when the clipapplier was first inserted into the patient. The same operationsdiscussed above can be performed until all of the clips in the barrelmagazine are spent.

A graph 71200 of a firing member of a clip applier, such as any of theclip appliers described herein, for example, is illustrated in FIG. 71.The graph 71200 shows the relationship between the force required toadvance a clip within the clip applier (i.e., via the firing member)versus displacement. With further reference to FIG. 71, a graph 71300 ofthe same clip applier is illustrated showing the relationship betweenthe voltage applied to the motor driving the firing member of the clipapplier versus time. The motor controller of the clip applier canmonitor the current being drawn by the motor and/or the force beingapplied to the firing member by the motor to detect a clip feed jam, oran irregular force within the clip applier, and then prevent furtheradvancement of the firing member by implementing changes to the voltageapplied to electric motor, as seen in graph 71300. In other words, ifthe monitored force exceeds a threshold value, and/or the monitoredmotor current exceeds a threshold value, during the clip feed step, themotor controller can, one, reduce the magnitude of the voltage potentialbeing applied to the motor for a period of time and, two, further assessthe force within the firing system and/or further assess the electricalcurrent being drawn by the motor. If the force and/or motor currentcontinue to increase with the continued application of voltage to themotor, the motor control system can stop the motor and/or reverse thedirection of the motor shaft to retract the firing member through ashort stroke distance to clear the jammed clip. Once the jammed clip iscleared, the clip applier can return to its normal operation and preparethe next clip to be advanced in accord with the normal operatingsequence of the clip applier.

Other embodiments are envisioned where clearing the jammed clip isaccomplished by interrupting the normal sequence of the end effector jawoperations. More specifically, once the clip jam is detected the controlsystem of the clip applier (i.e., motor controller, processor, andmemory) could request the clinician initiate a jam removal actuation.The jam removal actuation results in the jaws of the clip applier beingopened further than normal prior to another attempt to re-advance theclip. During the attempt to re-advance the clip, the acceptable loadthreshold, i.e., the current threshold and/or the force threshold, couldbe elevated above the normal thresholds previously discussed to insurethe clip is ejected from the jaws. Once the jammed clip has beenejected, the clip applier could return to its normal operation andprepare the next clip to be advanced in accord with the normal operatingsequence of the clip applier.

As mentioned above, certain clip appliers can be loaded with clipshaving a first size and/or a second size. The relative size of the clipscan be measured using any suitable dimension, such as the leg-to-legwidth of the clips, for example. First clips having a first width can bewider than second clips having a second width. In various instances, theclip applier can be loaded with only first clips, only second clips, orboth first and second clips at the same time. In any event, clips havingdifferent sizes may deform differently for a given closure stroke of theclip jaws. Thus, for instance, a first closure stroke of the clip jawsmay be more preferable for the first clips while a second closure strokeof the clip jaws may be more preferable for the second clips. Many ofthe clip appliers disclosed herein are capable of selectively applyingmore than one closure stroke to the clip jaws; however, in order toapply the correct closure stroke to a clip, the clip applier needs to beable to assess which size of clip is positioned within the clip jaws. Incertain instances, such information can be manually entered into thecontrol system of the clip applier by the clinician. Such an arrangementis convenient when the clips in the clip applier all have the same size.In various instances, the clip cartridge attached to the clip appliercomprises a marker, such as a microchip, for example, which can beevaluated by the control system and/or a sensor circuit in communicationwith the control system, for example. Such an arrangement is convenientwhen the clips in the clip cartridge all have the same size.

In various instances, further to the above, the clip applier can beconfigured to assess the clip positioned between the clip jaws of theclip applier to assess the size of the clip. Once a clip is loadedbetween the clip jaws, the control system can partially operate the jawclosure drive and observe the force within the jaw closure drive and/orthe current drawn by the electric motor of the jaw closure drive. Thecontrol system is configured to compare the measured data to data storedin a memory device, for example, to assess whether the clip between theclip jaws is a first clip or a second clip, or any other clip. Forinstance, if the measured force and/or motor current follows a firstprofile, then the control system will determine that the clip is a firstclip and then apply the first closure stroke. Similarly, the controlsystem will apply the second closure stroke if the measured force and/ormotor current follows a second profile for the second clip. As such, thecontrol system can use the jaw closure drive to apply a short evaluationclosure stroke to assess the clip size and then complete the fullclosure stroke as appropriate. In at least one instance, the controlsystem can reset the jaw closure drive after performing the shortevaluation closure stroke and then complete a full closure stroke asappropriate. In various instances, it is envisioned that the shortevaluation closure stroke does not plastically deform, or at leastsubstantially plastically deform, the clip.

Referring to FIG. 72, a graph 71400 of the force applied to a pair ofjaws of a clip applier versus time is illustrated. The control system ofthe clip applier can monitor the force within the crimping drive and/orthe electric current drawn by the motor to determine the amount of forceneeded to crimp a clip positioned within the jaws of the clip applier.This feedback force is initially dependent on the size and/or type ofclip that is within the jaws for a first portion of the closure strokeof the jaws. Once the size/type of clip is determined, the force appliedto the jaws of the clip applier can be adjusted for the remainder of thejaw closure stroke to crimp the clip with the proper amount of force.Such an arrangement is convenient when more than one size of clip hasbeen loaded into the clip applier. Other embodiments are envisionedwhere an adaptive control program change is initiated by the cartridgeidentifying itself to the clip applier upon insertion into the clipapplier. This allows the clip applier to update to the alternativecontrol program and thresholds (i.e., the forces applied to the jaws)for the size/type of clip loaded into the clip applier. Further, analternative to the identification of the cartridge could be thedetection of the loads needed to accomplish the first job of the clipapplier, which could be the advancement of a clip from the cartridge orpre-forming a clip within the jaws as discussed above. The first job ofthe clip applier may have a significantly higher load threshold neededto complete the operation and exceeding that threshold, or not, willthen determine the subsequent operations the clip applier and thethreshold limits of each operation.

Many of the clip appliers discussed herein have been discussed in thecontext that the clip jaws of the clip appliers are squeezed to crush aclip into its proper size. Other embodiments are envisioned in which aclip is elastically or resiliently stretched and then released once thetargeted tissue has been positioned within the stretched clip. Such anarrangement can be particularly useful when clamping or clipping bloodvessels, for example. In such instances, a clip can be released toresiliently return to, or at least toward, its unstretched position andclamp the blood vessel in an atraumatic, or a nearly atraumatic, manner.All of the clip appliers disclosed herein can be adapted to apply suchstretch-and-release clips. Moreover, further to the above, the clipappliers disclosed herein can be configured to apply both theclamp-to-crush clips and the stretch-and-release clips. Similar to theabove, the clip appliers would need to be able to identify the type ofclips contained therein in order to apply them properly to the patienttissue. Identification chips in the clip cartridges could be used forsuch purposes, for example.

FIG. 75 depicts a clip applier system 71500 in accordance with at leastone embodiment. The clip applier system 71500 comprises the clip applier70600 discussed above. The clip applier system 71500 further comprises amagnet aligned with one of the clips 70654 of the rotatable clipmagazine 70650. The clip applier system 71500 further comprises asensor, such as a Hall Effect sensor 71502, for example, fixedlypositioned within the ground portion 70612 of the clip applier 70600.The magnet can be sensed by the Hall Effect sensor 71502 and, based onthe voltage potential created by the Hall Effect sensor, the controlsystem of the clip applier 71500 can determine the radial location andorientation of the magnet and, thus, the radial location and orientationof the clip magazine 70650. When the magnet is in a first position71504, referring to FIG. 76, the rotatable clip magazine 70650 is loadedwith a full compliment of clips 70654 and one of the clips 70654 can beadvanced out of the rotatable clip magazine 70650 into the end effector70605. The rotatable clip magazine 70650 can then be cycled (e.g.,rotated) as discussed above, causing the magnet to move between thefirst position 71504 and a second position 71506. Another clip 70654 canbe advanced out of the rotatable clip magazine 70650 and the rotatableclip magazine 70650 can be cycled again, causing the magnet to move to athird position 71508. Another clip 70654 can be advanced out of therotatable clip magazine 70650 and the rotatable clip magazine 70650 canbe cycled again, causing the magnet to move to a fourth position 71510.Further, another clip 70654 can be advanced out of the rotatable clipmagazine 70650 and the rotatable clip magazine 70650 can be cycledagain, causing the magnet to move to a fifth position 71512. In thefifth position 71512, the last clip 70654 in the rotatable clip magazine70650 can be advanced out of the rotatable clip magazine 70650. Thus,the clip applier system 71500 can determine the status of the clipmagazine 70650 (i.e., the number of clips remaining) depending on theposition of the magnet relative to the Hall Effect sensor 71502. Furtherto the above, FIG. 76 depicts the voltage potential generated by theHall Effect sensor 71502 depending on the position of the magnet.

In at least one alternative embodiment of the clip applier system 71500,the clip magazine 70650 further comprises an extension member, or bar,that extends proximally from the clip magazine 70650 once all of theclips 70654 have been ejected from the clip magazine 70650. Theextension member is sensed by the Hall Effect sensor 71502 and/oranother electrical sensor within the clip applier 70600. When theextension member is detected by the clip applier system 71500, themechanical systems (i.e., the feeder member 70630, firing member 70640,and drive tube 70620) of the clip applier 70600 can be locked out toprevent further actuation.

FIG. 77 depicts a clip applier 71600. The clip applier 71600 comprises afirst jaw 71610 a and a second jaw 71610 b moveable relative to eachother between open and closed positions. The clip applier 71600 isconfigured to receive a clip 71604 which is crimped by the first jaw71610 a and the second jaw 71610 b when the first jaw 71610 a and thesecond jaw 71610 b are moved toward the closed position. The clipapplier 71600 comprises a resistive sensing circuit configured todetermine the position of the clip 71604 within the clip applier 71600.The resistive sensing circuit comprises a supply voltage source 71602which supplies current through a first lead 71620 a, the first jaw 71610a, the clip 71604, the second jaw 71610 b, and a Resistor 71620 b andback to a return 71606 where the current can be measured. When the clip71604 is moved distally though the clip applier, such as to the positionshown by clip 71604′, for example, the path through which the currentflows is larger (i.e., larger than the path for clip 71604) and theresistance within the path is greater and, as a result, the currentmeasured at the return 71606 will be smaller. Thus, the current measuredat the return 71606 is directly proportional to the position of the clip71604 within the clip applier 71600. The control system of the clipapplier is configured to use the magnitude of the current in thissensing circuit to assess the position of the clip 71604′ within thejaws 71610 a and 71610 b. Higher current magnitudes indicate that theclip 71604′ is more proximal and lower current magnitudes indicate thatthe clip 71604's is more distal, while intermediate current magnitudesindicate that the clip 71604′ is positioned in the middle of the jaws71610 a and 71610 b.

Referring still to FIG. 77, the clip applier 71600 further comprises asecond resistive sensing circuit configured to determine when the firstjaw 71610 a and the second jaw 71610 b are in the closed position. Morespecifically, the supply voltage supplies current which flows through afirst lead 71630 a connected to the first jaw 71610 a. The first lead71630 a is insulated from the first jaw 71610 a, i.e., it does not allowcurrent to flow into the first jaw 71610 a. When the first jaw 71610 aand the second jaw 71610 b are in the closed position, the first lead71630 a contacts a second lead 71630 b connected to the second jaw 71610b which allows current to flow into a resistor 71630 c and into thereturn 71606 where the current can be measured. The second lead 71630 bis also insulated from the second jaw 71610 b. Thus, when the first jaw71610 a and the second jaw 71610 b are in the closed position, thecontrol system, via the return, will sense a current determined by asecond resistance through the resistor 71630 c which indicates that thefirst and second jaws 71610 a, 71610 b are in the closed position. Thecontrol system may, at the same time, also sense the resistance throughresistor 71620 b which indicates the position of the clip 71604 withinthe clip applier 71600. Other embodiments are envisioned where only oneof the resistive sensing circuits discussed above are utilized with theclip applier 71600.

FIGS. 78A and 78B depict a variable resistance system for use with aclip applier 71650 configured to gather information (i.e., data) on theposition of the clip jaws and the formation of the clip during acrimping stroke. The clip applier 71650 is similar to clip applier71600, for example, in many respects. The clip applier 71650 comprises afirst jaw 71650 a and a second jaw 71650 b moveable relative to eachother between an open position (FIG. 78A), a partially closed position(FIG. 78B) and a closed position. The clip applier 71650 is configuredto receive a clip 71654 which is crimped by the first and second jaws71650 a, 71650 b when the first and second jaws 71650 a, 71650 b aremoved toward the closed position. The legs of the clip 71654 positionedwithin the first and second jaws 71650 a, 71650 b extend outwardly intoengagement with the first and second jaws 71650 a, 71650 b to ensure theclip 71654 is properly seated therebetween (i.e., so there is no slop orplay between the clip 71654 and the first and second jaws 71650 a, 71650b). In various instances, the legs of the clip are slightly deflectedinwardly when the clip is fed into the first and second jaws 71650 a,71650 b. The variable resistance system of the clip applier 71650 isdescribed in further detail below.

The variable resistance system comprises three return paths throughwhich an electrical current can flow and be sensed by the control systemof the clip applier in order to determine the position of the first andsecond jaws 71650 a, 71650 b relative to each other, and to sense theformation of the clip 71654. The first return path 71660 comprises thesecond jaw 71650 b. The second return path 71670 comprises a variableresistor configured to determine the position of the first jaw 71650 aand the second jaw 71650 b relative to each other. More specifically, asthe first jaw 71650 a and the second jaw 71650 b are moved from the openposition (FIG. 78A) toward the closed position the resistance in thevariable resistor will change. The third return path 71680 comprisesanother variable resistor at the distal end of the second jaw 71650 bwhich is insulated from the second jaw 71650 b. When the first jaw 71650a and the second jaw 71650 b are in the open position (FIG. 78A), theclip 71654 is in contact with the first return path 71660 and the thirdreturn path 71680. When the first jaw 71650 a and the second jaw 71650 nare in the partially closed position (FIG. 78B), the clip 71654 is onlyin contact with the first return path 71660. When the first jaw 71650 aand the second jaw 71650 b are in the closed position the clip 71654 hasbeen fully crimped and is once again in contact with the first returnpath 71660 and the third path 71680. Throughout the movement of thefirst jaw 71650 a and the second jaw 71650 b between the open position,the partially closed position, and the closed position, the secondreturn path 71670 determines the position of the first jaw 71650 arelative to the second jaw 71650 b. Thus, the variable resistance systemcan determine jaw position and sense clip formation throughout the clipformation process by determining the resistance through each of thethree paths.

FIG. 79 depicts a clip applier jaw 71700 in accordance with at least oneembodiment. The clip applier jaw 71700 is configured to move toward andaway from another clip applier jaw and is further configured to crimp aclip as discussed above in relation to various embodiments disclosedherein. The clip applier comprises a proximal strain gauge 71720 and adistal strain gauge 71730, and/or any number of suitable strain gauges.The proximal strain gauge 71720 and the distal strain gauge 71730 arepositioned on a face 71710 of the clip applier jaw 71700. Otherembodiments are envisioned with more than two strain gauges spaced alongany suitable face of the clip applier jaw 71700 and/or built into theclip applier jaw 71710 itself. The proximal strain gauge 71720 is partof a proximal strain gauge circuit and generates a voltage signalindicative of the strain within the clip applier jaw 71700 in a firstlocation and the distal strain gauge 71730 is part of a distal straingauge circuit and generates a voltage signal indicative of the strainwithin the clip applier jaw 71700 in a second location. The proximal anddistal strain gauge circuits are in communication with the controlsystem of the clip applier and, as a clip is formed between the clipapplier jaw 71700 and another clip applier jaw, different levels ofstrain will be detected by the control system at the first location andthe second location.

Referring to FIG. 80, a graph 71800 of the strain (measured in Volts,but could be more conveniently illustrated in mV) within the proximalstrain gauge 71720 and the distal strain gauge 71730 at various stagesof clip formation is depicted. Upon the initial placement of a clipbetween the clip applier jaws, the clip legs of certain clips are biasedoutwardly into engagement with the jaws, as discussed above. In suchinstances, a larger strain may be measured in the proximal strain gauge71720 as compared to the distal strain gauge 71730. The difference inthe voltages within the strain gauges 71720, 71730 at this stage isvoltage A as depicted in FIG. 80. As the jaws of the clip applier beginto form the clip, the reading from the proximal strain gauge 71720 willexceed a pre-formed strain threshold T_(PF) while the reading from thedistal strain gauge 71730 remains below the pre-formed strain thresholdT_(PF). This can indicate that the clip has only been formed at or nearthe proximal strain gauge 71720. The difference in the voltages betweenthe readings of the strain gauges 71720, 71730, at this stage, ismeasured to be A′. As the jaws of the clip applier form the clipfurther, the reading from the distal strain gauge 71730 will eventuallyexceed the pre-formed strain threshold T_(PF) and the reading from theproximal strain gauge 71720 will eventually exceed a full-formed strainthreshold T_(FF). This can indicate that the clip has been fully formedat or near the proximal strain gauge 71720 and has begun to be deformedat or near the distal strain gauge 71730. When the readings from theproximal strain gauge 71720 and the distal strain gauge 71730 are bothmeasured to be beyond the full-formed threshold T_(FF) and thepre-formed threshold T_(PF), respectively, the difference in the straingauge readings is measured as A″ as depicted in FIG. 80. Further, as thejaws of the clip applier form the clip further, the reading from thedistal strain gauge 71730 will eventually exceed the full-formed strainthreshold T_(FF) and the reading from the proximal strain gauge 71720will continue to increase above the full-formed strain threshold T_(FF).When the reading from the proximal strain gauge 71720 and the distalstrain gauge 71730 are measured to both be beyond the full-formedthreshold T_(FF), the difference in the strain gauge readings ismeasured as A′″ as depicted in FIG. 80.

Further to the above, the state of the clip can be determined bymeasuring the differences between the readings of the proximal straingauge 71720 and the distal strain gauge 71730 throughout the formationof a clip. More specifically, a difference in voltage measuring Aindicates that the clip has yet to be deformed. A difference in voltagemeasuring A′ indicates that only a proximal portion of the clip has beendeformed. A difference in voltage measuring A″ indicates that theproximal portion of the clip has been fully formed and the distalportion of the clip has begun to be deformed. And lastly, a differencein the voltage measuring A′″ indicates that both the proximal and distalportions of the clip have been fully formed.

As discussed above, a clip applier is often inserted into a patientthrough a trocar. As a result, the diameter of the passageway throughthe trocar dictates a lot of the design considerations of the clipapplier—especially of the portions of the clip applier that are insertedthrough and/or into the trocar passageway. That said, there is oftenmotivation to make trocars as narrow as possible to reduce the size ofthe incisions in the patient, among other reasons. As such, narrowtrocars, and narrow trocar passageways, present significant designconstraints and often limit the widths of the clips that can be used.With this in mind, clip appliers are disclosed herein which areconfigured to store the clips in a small configuration and then enlargethe clips once they are on the other side of the trocar. Such anarrangement can allow clips to be used which, in their enlarged state,exceed the diameter of the trocar that they were inserted through.

FIGS. 81A and 81B depict a clip applier 71900 in accordance with atleast one embodiment. The clip applier 71900 comprises a first jaw 71910a and a second jaw 71910 b moveable relative to each other about a pivotpin 71912 between a closed position, a home position (FIG. 81A), and anopen position (FIG. 81B). The clip applier 71900 further comprises a cammember 71920 configured to move the first jaw 71910 a and the second jaw71910 b between the closed position, the home position, and the openposition. More specifically, the first jaw 71910 a and the second jaw71910 b are moved to the open position by the cam member 71920 when thecam member 71920 is moved to a fully retracted position (FIG. 81B) dueto the cam member 71920 engaging a first jaw cam 71914 a on the firstjaw 71910 a and a second jaw cam 71914 b on the second jaw 71910 b.Furthermore, the first jaw 71910 a and the second jaw 71910 b are movedto the home position by the cam member 71920 when the cam member 71920is moved distally to a home position depicted in FIG. 81A (i.e., the cammember 71920 is no longer engaging the first jaw cam 71914 a and thesecond jaw cam 71914 b allowing the first jaw 71910 a and the second jaw71910 b to assume the home position). Further still, the first jaw 71910a and the second jaw 71910 b are moved to the closed position by the cammember 71920 when the cam member 71920 is moved distally to a fullyadvanced position due to the cam member 71920 cammingly engaging theouter surfaces of the first jaw 71910 a and the second jaw 71910 b. Thefirst jaw 71910 a and the second jaw 71910 b are configured to receive aclip 71904 therein to be expanded during a pre-form operation andcrimped during a crimping operation. FIG. 81A depicts the clip 71904 ina storage configuration when the first jaw 71910 a and the second jaw71910 b are in the home position. The clip 71904 can be a 5 mm clip inthe storage configuration, for example. Expansion of the clip 71904during the pre-form operation and crimping of the clip 71904 during thecrimping operation are described in further detail below.

The first jaw 71910 a and the second jaw 71910 b comprise pre-formingfeatures, or protrusions 71930 a and 71930 b, similar to protrusions70126 a and 70126 b discussed above. The protrusions 71930 a and 71930 bengage the inner surfaces of the clip 71904 and expand the clip 71904from the storage configuration (FIG. 81A) to a firing configuration(FIG. 81B) when the first jaw 71910 a and the second jaw 71910 b aremoved to the open position. For example, the clip 71904 is expanded fromthe storage configuration where the clip 71904 has an approximately 5 mmwidth to a firing configuration where the clip 71904 has anapproximately 10 mm width. That said, a clip can have any suitablestored width and any suitable expanded width. After the clip 71904 hasbeen expanded to the firing configuration, a firing member advances theclip over the protrusions 71930 a, 71930 b into a crimping positionwithin the first jaw 71910 a and the second jaw 71910 b. The protrusions71930 a and 71930 b comprise angled portions which allow the clip 71904to slide over the protrusions 71930 a and 71930 b when advanced by thefiring member. Once a clip is in the crimping position, the cam member71920 is advanced distally to the fully advanced position during acrimping stroke to move the first jaw 71910 a and the second jaw 71910 bto the closed position, and, thus, crimp the clip 71904 within thecrimping chamber.

Further to the above, the clip applier 71900 further comprises a sensorarray 71940 that detects a magnet 71950 included in one of the first jaw71910 a and the second jaw 71910 b. The sensor array 71940 detects thelocation of the magnet 71950 relative to the sensor array 71940 in orderto determine the position of the first jaw 71910 a and the second jaw71910 b relative to each other during the operation of the clip applier71900.

As discussed herein, clip appliers are loaded with clips in a variety ofmanners. For instance, clips can be loaded into a clip applier by way ofa clip cartridge. Such clip cartridges can comprise clips stacked alonga longitudinal axis, for example. Such clip cartridges can also compriseclips stacked along an axis which is transverse to the longitudinal axisof the clip applier. Certain cartridges are stored in a circumferentialconfiguration, as described above. That being said, some clip appliersmay be configured to hold only one clip at a time. The teachingsprovided herein are adaptable to such clip appliers. In at least oneinstance, a one-clip clip applier, for example, can be used with adocking station comprising a plurality of clips stored therein. In suchinstances, the clinician can use the docking station to re-supply a clipto the one-clip clip applier after each use of the clip applier. Incertain instances, the docking station can be positioned in the patientwhich prevents the need to remove the clip applier from the patient suchthat the clip applier can be reloaded. In at least one instance, asdiscussed below, the docking station can be attached to a trocarinserted into the patient, for example. The above being said, the ideaof a docking station positioned within a patient can also be used with amulti-clip clip applier. In such instances, one or more clips from thedocking station can be loaded into the multi-clip clip applier withouthaving to remove the clip applier from the patient.

Turning to FIGS. 82 and 83, a clip applier system 72000 is depicted. Theclip applier system comprises a trocar 72010, a clip magazine 72050, anda clip applier 72020. The clip applier 72020 comprises an elongate shaft72011 extending from a housing, an articulation joint 72022 extendingfrom the elongate shaft 72011, and an end effector 72024 extending fromthe articulation joint 72022. The end effector 72024 comprises a firstjaw 72024 a and a second jaw 72024 b moveable relative to each otherbetween an open position and a closed position. The end effector 72024is articulable relative to the elongate shaft 72011 about thearticulation joint 72022. The clip magazine 72050 comprises an opening72051 (see FIG. 82) through the clip magazine 72050. Prior to insertionof the clip applier 72020 through the trocar 72010, the clip magazine72050 is positioned within the patient and attached to the distal end ofthe trocar 72010. The opening 72051 allows the clip magazine 72050 to bereceived and attached to the distal end of the trocar 72010 as depictedin FIG. 83. The clip magazine 72050 can be threadably attached to thedistal end of the trocar 72010, for example. The clip applier 72020 isthen inserted through the trocar 72010 and the opening 72051 of the clipmagazine 72050 until the end effector 72024 of the clip applier 72020 ispositioned distal to the clip magazine 72050. As the clip applier 72020is retracted toward the clip magazine 72050, the clip applier 72020engages the clip magazine 72050 to eject a clip from the clip magazine72050 into the end effector of the clip applier 72020, as discussed ingreater detail below.

Turning to FIGS. 85A and 85B, the clip magazine 72050 further comprises,a leaf spring 72052, a plurality of clips 72054 removably stored in theclip magazine 72050, a spring 72059, a sled 72058, and a loading arm72056. The leaf spring 72052 prevents the clips 72054 from falling outof the clip magazine 72050 inadvertently. The spring 72059 biases thesled 72058 distally to bias the clips 72054 toward the loading arm72056. The loading arm 72056 grasps and holds a clip 72054 in placeuntil acted upon by the clip applier 72020. To this end, the loading arm72056 engages a jaw wing 72026 of the clip applier 72020 as the clipapplier 72020 is retracted towards the clip magazine 72050 (i.e.,proximally). When the jaw wing 72026 is engaged by the loading arm72056, the jaw wing 72026 moves proximally and the loading arm 72056rotates toward the end effector 72024 to load a clip 72054 from the clipmagazine 72050 into the end effector 72024 of the clip applier 72020.FIGS. 84A-84C depict the movements of the jaw wing 72024 and the loadingarm 72056 as the clip applier 72020 is retracted towards the clipmagazine 72050. After a clip 72054 has been loaded into the end effector72024, the clip applier 72024 can be moved distally to a desiredlocation within the patient to crimp the clip 72054 around patienttissue. After the clip 72054 is crimped and released, the clip applier72020 can be retracted toward the clip magazine 72050 (i.e., proximally)to engage the jaw wing 72026 with the loading arm 72056 of the clipmagazine 72050 to load another clip into the clip applier 72020. Thisprocess can be repeated until all of the clips 72054 have been depletedfrom the clip magazine 72050, and/or until a suitable number of clipshave been applied.

Turning now to FIGS. 86A and 86B, the relationship between the jaw wing72026 and the first and second jaws 72024 a and 72024 b of the clipapplier 72020 is depicted. The jaw wing 72026 is operably engaged withthe first and second jaws 72024 a and 72024 b such that, when the firstand second jaws 72024 a and 72024 b are in the closed position (FIG.86B), the jaw wing 72026 is retracted. To this end, the clip applier72020 can be inserted through the clip magazine 72050 without the jawwing 72026 engaging the loading arm 72056 of the clip magazine 72050.Other embodiments are envisioned where the clip applier 72020 engagesthe clip magazine 72050 to load a clip 72054 into the end effector 72024when the clip applier 72020 is moved from a proximal position behind theclip magazine 72050 to a distal position beyond the clip magazine 72050.

A clip applier 73000 is depicted in FIGS. 87A-87D. The clip applier73000 comprises an elongate shaft 73010 extending from a housing, anarticulation joint 73020 extending from the elongate shaft 73010, amagazine housing 73030 extending from the articulation joint 73020, andan end effector 73040 extending from the magazine housing 73030. The endeffector 73040 comprises a first jaw 73040 a and a second jaw 73040 bmoveable relative to each other between an open position and a closedposition. The magazine housing 73030 comprises a bottom housing 73030 band a top housing 73030 a. The top housing 73030 a is movable relativeto the bottom housing 73030 b between an open position (FIG. 87A) and aclosed position (FIG. 87C) about a pivot pin 73032 attached to thearticulation joint 73020. The magazine housing 73030 can receive a clipmagazine 73050 comprising a plurality of clips 73054 stored therein. Theclips 73054 are loaded into the clip magazine 73030 and are locked inplace by a biasing member, or leaf spring 73056. The leaf spring 73056prevents the clips 73054 from being ejected form the clip magazine 73050until the clip magazine 73050 is seated in the magazine housing 73030,as discussed in greater detail below.

The clip magazine 73050 further comprises notches 73058 on either sideof the clip magazine 73050. To properly seat the clip magazine 73050 inthe magazine housing 73030, the notches 73058 of the clip magazine 73050are aligned with protrusions 73034 of the magazine housing 73030 to seatand align the clip magazine 73050 in the magazine housing 73030 asdepicted in FIG. 87B. Once the clip magazine 73050 is installed into themagazine housing 73030, the top housing 73030 a can be moved to theclosed position as depicted in FIG. 87C. The top housing 73030 acomprises a lockout release, or protrusion 73032, that engages the leafspring 73056 of the clip magazine 73050 when the clip magazine 73050 isinstalled in the magazine housing 73030 and the top housing 73030 a isin the closed position as depicted in FIG. 87D. When the leaf spring73056 is depressed by the protrusion 73032, the clips 73054 are nolonger locked into position within the clip magazine 73050 and can beejected from the clip magazine 73050 into the end effector 73040 by afiring member.

Turning now to FIGS. 88A-88D, after all of the clips 73054 have beenejected from the clip magazine 73050, the clip magazine 73050 can belocked out when removed from the magazine housing 73030 to prevent theclip magazine 73050 from being re-installed into the magazine housing73030 until reloaded with at least one new clip 73054. Morespecifically, the clip magazine 73030 comprises a sled 73052 that movesthrough the clip magazine 73030 as the clips 73054 are ejected. The sled73052 comprises spring loaded detents 73059 which align with the notches73058 in the clip magazine 73050 when the last clip 73054 has beenejected form the clip magazine 73050. When the clip magazine 73050 isinstalled in the magazine housing 73030 and the clip magazine 73050 hasbeen spent, the spring loaded detents 73059 are biased against theprotrusions 73034 as depicted in FIGS. 88B and 88D. After the clipmagazine 73050 is removed from the magazine housing 73030, the springloaded detents 73059 protrude through the notches 73058 to lock the sled73052 into place as depicted in FIG. 88A. The spent clip magazine 73050cannot be re-installed into the magazine housing 73030 unless at leastone clip 73054 is loaded into the clip magazine 73050. Morespecifically, until the sled 73052 is retracted to disengage the springloaded detents 73059 from the notches 73058 (i.e., at least one clip73054 is installed) the clip magazine 73050 cannot be installed into themagazine housing 73030 because the spring loaded detents 73059 occupythe notches 73058 and will not allow the notches 73058 to properly alignand seat with the protrusions 73034 of the magazine housing 73030.

Other embodiments are envisioned where a clip applier system comprises aclip applier, a trocar, and a sensing system. The clip applier of theclip applier system is similar to clip applier 72020 in many respectsand the trocar is similar to the trocar 72010 in many respects. Thetrocar can comprise a sensor, such as a Hall Effect sensor, for example,attached to, or near, the distal end of the trocar. The clip applierfurther comprises a detectable element, such as a magnet, for example,positioned in the end effector of the clip applier. The magnet in theend effector of the clip applier and the Hall Effect sensor on thedistal end of the trocar are included in the sensing system. The sensingsystem is in signal communication with the control system of the clipapplier via a wireless signal transmitter in the trocar and a wirelesssignal receiver in the clip applier. The control system of the clipapplier is configured to automatically control the opening and closingof the jaws of the end effector depending on the position of the magnetrelative to the Hall Effect sensor. More specifically, when the magnetin the jaws is positioned a predetermined distance distal to the HallEffect sensor of the trocar—which indicates that the jaws have passedthrough the trocar, the clip jaws are automatically moved to an openposition by the control system of the clip applier. Moreover, thecontrol system of the clip applier can also automatically load a clipinto the open jaws. Such an arrangement reduces the time needed to loadthe clip applier after being inserted into a patient. Further, when themagnet in the jaws is approaching the Hall Effect sensor of the trocarfrom a distal position (i.e., the clip applier is being retractedproximally toward the trocar) the control system automatically moves thejaws to a closed position to allow the clip applier to be retractedthrough the trocar.

FIG. 89 is a logic diagram of a control system 75000 for use with any ofthe various clip appliers described herein. The control system 75000comprises a control circuit. The control circuit includes amicrocontroller 75040 comprising a processor 75020 and a memory 75030.One or more sensors, such as sensor 75080, sensor 75090, sensor 71502,and sensor array 71940, for example, provide real time feedback to theprocessor 75020. The control system 75000 further comprises a motordriver 75050 configured to control an electric motor 75010 and atracking system 75060 configured to determine the position of one ormore longitudinally movable components in the clip applier, such asfiring member 70165 (FIG. 35A), crimping drive 70180 (FIG. 36), feedermember 70630 (FIG. 53), firing member 70640 (FIG. 53), and closure tube70620 (FIG. 53), for example. The tracking system 75060 is alsoconfigured to determine the position of one or more rotationalcomponents in the clip applier, such as the rotatable clip magazine70650 (FIG. 52), for example. The tracking system 75060 providesposition information to the processor 75020, which can be programmed orconfigured to, among other things, determine the position of therotatable clip magazine 70650 (FIG. 52), determine the position of thefiring member, feeder member, closure tube and/or crimping drive, aswell as determine the orientation of the jaws of the clip applier. Themotor driver 75050 may be an A3941 available from Allegro Microsystems,Inc., for example; however, other motor drivers may be readilysubstituted for use in the tracking system 75060. A detailed descriptionof an absolute positioning system is described in U.S. PatentApplication Publication No. 2017/0296213, entitled SYSTEMS AND METHODSFOR CONTROLLING A SURGICAL STAPLING AND CUTTING INSTRUMENT, the entiredisclosure of which is hereby incorporated herein by reference.

The microcontroller 75040 may be any single core or multicore processorsuch as those known under the trade name ARM Cortex by TexasInstruments, for example. In at least one instance, the microcontroller75040 is a LM4F230H5QR ARM Cortex-M4F Processor Core, available fromTexas Instruments, for example, comprising on-chip memory of 256 KBsingle-cycle flash memory, or other non-volatile memory, up to 40 MHz, aprefetch buffer to improve performance above 40 MHz, a 32 KBsingle-cycle serial random access memory (SRAM), internal read-onlymemory (ROM) loaded with StellarisWare® software, 2 KB electricallyerasable programmable read-only memory (EEPROM), one or more pulse widthmodulation (PWM) modules and/or frequency modulation (FM) modules, oneor more quadrature encoder inputs (QEI) analog, one or more 12-bitAnalog-to-Digital Converters (ADC) with 12 analog input channels, forexample, details of which are available from the product datasheet.

In various instances, the microcontroller 75040 comprises a safetycontroller comprising two controller-based families such as TMS570 andRM4x known under the trade name Hercules ARM Cortex R4, also by TexasInstruments. The safety controller may be configured specifically forIEC 61508 and ISO 26262 safety critical applications, among others, toprovide advanced integrated safety features while delivering scalableperformance, connectivity, and memory options.

The microcontroller 75040 is programmed to perform various functionssuch as precisely controlling the speed and/or position of the firingmember, feeder member, crimping drive or closure tube of any of the clipappliers disclosed herein, for example. The microcontroller 75040 isalso programmed to precisely control the rotational speed and positionof the end effector of the clip applier and the articulation speed andposition of the end effector of the clip applier. In various instances,the microcontroller 75040 computes a response in the software of themicrocontroller 75040. The computed response is compared to a measuredresponse of the actual system to obtain an “observed” response, which isused for actual feedback decisions. The observed response is afavorable, tuned, value that balances the smooth, continuous nature ofthe simulated response with the measured response, which can detectoutside influences on the system.

The motor 75010 is controlled by the motor driver 75050. In variousforms, the motor 75010 is a DC brushed driving motor having a maximumrotational speed of approximately 25,000 RPM, for example. In otherarrangements, the motor 75010 includes a brushless motor, a cordlessmotor, a synchronous motor, a stepper motor, or any other suitableelectric motor. The motor driver 75050 may comprise an H-bridge drivercomprising field-effect transistors (FETs), for example. The motordriver 75050 may be an A3941 available from Allegro Microsystems, Inc.,for example. The A3941 motor driver 75050 is a full-bridge controllerfor use with external N-channel power metal oxide semiconductor fieldeffect transistors (MOSFETs) specifically designed for inductive loads,such as brush DC motors. In various instances, the motor driver 75050comprises a unique charge pump regulator provides full (>10 V) gatedrive for battery voltages down to 7 V and allows the A3941 motor driver75050 to operate with a reduced gate drive, down to 5.5 V. A bootstrapcapacitor may be employed to provide the above-battery supply voltagerequired for N-channel MOSFETs. An internal charge pump for thehigh-side drive allows DC (100% duty cycle) operation. The full bridgecan be driven in fast or slow decay modes using diode or synchronousrectification. In the slow decay mode, current recirculation can bethrough the high-side or the lowside FETs. The power FETs are protectedfrom shoot-through by resistor adjustable dead time. Integrateddiagnostics provide indication of undervoltage, overtemperature, andpower bridge faults, and can be configured to protect the power MOSFETsunder most short circuit conditions. Other motor drivers may be readilysubstituted.

The tracking system 75060 comprises a controlled motor drive circuitarrangement comprising one or more position sensors, such as the sensor75080, sensor 75090, sensor 71502, and sensory array 71940, for example.The position sensors for an absolute positioning system provide a uniqueposition signal corresponding to the location of a displacement member.As used herein, the term displacement member is used generically torefer to any movable member of any of the clip appliers disclosedherein. In various instances, the displacement member may be coupled toany position sensor suitable for measuring linear displacement orrotational displacement. Linear displacement sensors may include contactor non-contact displacement sensors. The displacement sensors maycomprise linear variable differential transformers (LVDT), differentialvariable reluctance transducers (DVRT), a slide potentiometer, amagnetic sensing system comprising a movable magnet and a series oflinearly arranged Hall Effect sensors similar to the arrangementillustrated in FIG. 75, a magnetic sensing system comprising a fixedmagnet and a series of movable linearly arranged Hall Effect sensorssimilar to the arrangement illustrated in FIGS. 81A and 81B, an opticalsensing system comprising a movable light source and a series oflinearly arranged photo diodes or photo detectors, or an optical sensingsystem comprising a fixed light source and a series of movable linearlyarranged photo diodes or photo detectors, or any combination thereof.

The position sensors 75080, 75090, 71502, and 71940 for example, maycomprise any number of magnetic sensing elements, such as, for example,magnetic sensors classified according to whether they measure the totalmagnetic field or the vector components of the magnetic field. Thetechniques used to produce both types of magnetic sensors encompass manyaspects of physics and electronics. The technologies used for magneticfield sensing include search coil, fluxgate, optically pumped, nuclearprecession, SQUID, Hall-Effect, anisotropic magnetoresistance, giantmagnetoresistance, magnetic tunnel junctions, giant magnetoimpedance,magnetostrictive/piezoelectric composites, magnetodiode,magnetotransistor, fiber optic, magnetooptic, and microelectromechanicalsystems-based magnetic sensors, among others.

In various instances, one or more of the position sensors of thetracking system 75060 comprise a magnetic rotary absolute positioningsystem. Such position sensors may be implemented as an AS5055EQFTsingle-chip magnetic rotary position sensor available from AustriaMicrosystems, AG and can be interfaced with the controller 75040 toprovide an absolute positioning system. In certain instances, a positionsensor comprises a low-voltage and low-power component and includes fourHall-Effect elements in an area of the position sensor that is locatedadjacent a magnet. A high resolution ADC and a smart power managementcontroller are also provided on the chip. A CORDIC processor (forCoordinate Rotation Digital Computer), also known as the digit-by-digitmethod and Volder's algorithm, is provided to implement a simple andefficient algorithm to calculate hyperbolic and trigonometric functionsthat require only addition, subtraction, bitshift, and table lookupoperations. The angle position, alarm bits, and magnetic fieldinformation are transmitted over a standard serial communicationinterface such as an SPI interface to the controller 75040. The positionsensors can provide 12 or 14 bits of resolution, for example. Theposition sensors can be an AS5055 chip provided in a small QFN 16-pin4×4×0.85 mm package, for example.

The tracking system 75060 may comprise and/or be programmed to implementa feedback controller, such as a PID, state feedback, and adaptivecontroller. A power source converts the signal from the feedbackcontroller into a physical input to the system, in this case voltage.Other examples include pulse width modulation (PWM) and/or frequencymodulation (FM) of the voltage, current, and force. Other sensor(s) maybe provided to measure physical parameters of the physical system inaddition to position. In various instances, the other sensor(s) caninclude sensor arrangements such as those described in U.S. Pat. No.9,345,481, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,which is hereby incorporated herein by reference in its entirety; U.S.Patent Application Publication No. 2014/0263552, entitled STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, which is hereby incorporatedherein by reference in its entirety; and U.S. patent application Ser.No. 15/628,175, entitled TECHNIQUES FOR ADAPTIVE CONTROL OF MOTORVELOCITY OF A SURGICAL STAPLING AND CUTTING INSTRUMENT, which is herebyincorporated herein by reference in its entirety. In a digital signalprocessing system, absolute positioning system is coupled to a digitaldata acquisition system where the output of the absolute positioningsystem will have finite resolution and sampling frequency. The absolutepositioning system may comprise a compare and combine circuit to combinea computed response with a measured response using algorithms such asweighted average and theoretical control loop that drives the computedresponse towards the measured response. The computed response of thephysical system takes into account properties like mass, inertial,viscous friction, inductance resistance, etc., to predict what thestates and outputs of the physical system will be by knowing the input.

The absolute positioning system provides an absolute position of thedisplacement member upon power up of the instrument without retractingor advancing the displacement member to a reset (zero or home) positionas may be required with conventional rotary encoders that merely countthe number of steps forwards or backwards that the motor 75010 has takento infer the position of a device actuator, a firing member, a feederdrive, a crimping drive, a closure tube, and the like.

A sensor 75080 comprising a strain gauge or a micro-strain gauge, forexample, is configured to measure one or more parameters of the endeffector of the clip applier, such as, for example, the strainexperienced by the jaws during a crimping operation. In one embodiment,the sensor 75080 can comprise the strain gauges 71720 and 71730 (FIG.79) discussed in greater detail above, for example. The measured strainis converted to a digital signal and provided to the processor 75020. Inaddition to or in lieu of the sensor 75080, a sensor 75090 comprising aload sensor, for example, can measure the closure force applied by theclosure drive system to the jaws of the clip applier. In variousinstances, a current sensor 75070 can be employed to measure the currentdrawn by the motor 75010. The force required to clamp the first andsecond jaws to crimp a clip can correspond to the current drawn by themotor 75010, for example. The measured force is converted to a digitalsignal and provided to the processor 75020. A magnetic field sensor canbe employed to measure the thickness of the captured tissue. Themeasurement of the magnetic field sensor can also be converted to adigital signal and provided to the processor 75020.

The measurements of the tissue compression, the tissue thickness, and/orthe force required to close the end effector and crimp a clip aroundtissue as measured by the sensors can be used by the controller 75040 tocharacterize the position and/or speed of the movable member beingtracked. In at least one instance, the memory 75030 may store atechnique, an equation, and/or a look-up table which can be employed bythe controller 75040 in the assessment. In various instances, thecontroller 75040 can provide the user of the clip applier with a choiceas to the manner in which the clip applier should be operated. To thisend, a display 75044 can display a variety of operating conditions ofthe clip applier and can include touch screen functionality for datainput. Moreover, information displayed on the display 75044 may beoverlaid with images acquired via the imaging modules of one or moreendoscopes and/or one or more additional surgical instruments usedduring the surgical procedure.

As discussed above, the clip appliers disclosed herein may comprisecontrol systems. Each of the control systems can comprise a circuitboard having one or more processors and/or memory devices. Among otherthings, the control systems are configured to store sensor data, forexample. They are also configured to store data which identifies thetype of clip applier attached to a handle or housing, such as handle 700(FIG. 29), for example. More specifically, the type of clip applier canbe identified when attached to the handle or housing by the sensors andthe sensor data can be stored in the control system. Moreover, they arealso configured to store data including whether or not the clip applierhas been previously used and/or how many clips have been ejected fromthe clip magazine or clip cartridge of the clip applier duringoperation. This information can be obtained by the control system toassess whether or not the clip applier is suitable for use and/or hasbeen used less than a predetermined number of times, for example.

The surgical instrument systems described herein are motivated by anelectric motor; however, the surgical instrument systems describedherein can be motivated in any suitable manner. In certain instances,the motors disclosed herein may comprise a portion or portions of arobotically controlled system. U.S. patent application Ser. No.13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example,discloses several examples of a robotic surgical instrument system ingreater detail, the entire disclosure of which is incorporated byreference herein.

EXAMPLES Example 1

A surgical device for clipping tissue comprising a housing comprising amotor, a shaft extending from the housing, an end effector extendingfrom the shaft, and a first clip magazine releasably attached to thesurgical device. The first clip magazine comprises a plurality of firstclips and is replaceable with a second clip magazine comprising aplurality of second clips. The surgical device further comprises afiring drive operably responsive to the motor. The firing drive isconfigured to move a first clip from the first clip magazine into theend effector when the first clip magazine is attached to the surgicaldevice. The firing drive is further configured to move a second clipfrom the second clip magazine into the end effector when the second clipmagazine is attached to the surgical device. The surgical device furthercomprises a crimping drive operably responsive to the motor. Thecrimping drive is configured to crimp the first clip positioned in theend effector during a first crimping stroke when the first clip magazineis attached to the surgical device. The crimping drive is furtherconfigured to crimp the second clip positioned in the end effectorduring a second crimping stroke when the second clip magazine isattached to the surgical device. The surgical device further comprises astrain gauge configured to measure the strain within the end effectorduring the first crimping stroke. The surgical device further comprisesa motor controller in signal communication with the motor and the straingauge. The motor controller is configured to modify the second crimpingstroke based on the measured strain in the end effector during the firstcrimping stroke.

Example 2

The surgical device of Example 1, wherein the housing comprises ahandle.

Example 3

The surgical device of Example 1, wherein the housing is couplable to arobotic system.

Example 4

The surgical device of Examples 1, 2, or 3, further comprising thesecond clip magazine.

Example 5

A surgical device for clipping tissue comprising a housing comprising amotor, a shaft extending from the housing, an end effector extendingfrom the shaft, and a first clip magazine comprising a first pluralityof clips. The first clip magazine is replaceable with a second clipmagazine comprising a second plurality of clips. The surgical devicefurther comprises a firing drive configured to move a first clip fromthe first clip magazine into the end effector when the first clipmagazine is attached to the surgical device. The firing drive is furtherconfigured to move a second clip from the second clip magazine into theend effector when the second clip magazine is attached to the surgicaldevice. The surgical device further comprises a crimping driveconfigured to perform a first crimping stroke when the first clipmagazine is attached to the surgical device. The crimping drive isfurther configured to perform a second crimping stroke when the secondclip magazine is attached to the surgical device. The surgical devicefurther comprises a strain gauge configured to measure the strain withinthe end effector during the first crimping stroke. The surgical devicefurther comprises a motor controller in signal communication with themotor and the strain gauge. The motor controller is configured to movethe crimping drive through a first crimping stroke with a first force.The motor controller is further configured to move the crimping drivethrough a second crimping stroke with a second force different than thefirst force. The second force is at least partially determined by thestrain measured during the first crimping stroke.

Example 6

The surgical device of Example 5, wherein the housing comprises ahandle.

Example 7

The surgical device of Example 5, wherein the housing is couplable to arobotic system.

Example 8

The surgical device of Examples 5, 6, or 7, further comprising thesecond clip magazine.

Example 9

A surgical device for clipping tissue comprising a housing comprising amotor, a shaft extending from the housing, and an end effector extendingfrom the shaft. The end effector comprises a first jaw and a second jaw.The first jaw and the second jaw are movable relative to each otherbetween an open position and a closed position. The surgical devicefurther comprises a first clip cartridge comprising a plurality ofclips. The first clip cartridge is removably attached to the surgicaldevice. The surgical device further comprises a second clip cartridgecomprising a plurality of clips. The second clip cartridge is removablyattachable to the surgical device when the first clip cartridge is notattached to the surgical device. The surgical device further comprises afeeder member configured to move each clip in the first clip cartridgeand each clip in the second clip cartridge into the end effector duringseparate firing strokes. The surgical device further comprises acrimping drive configured to move the first jaw and the second jawtoward the closed position during a crimping stroke for each clip in thefirst clip cartridge and each clip in the second clip cartridge. Thesurgical device further comprises a strain gauge positioned in the endeffector. The strain gauge is configured to measure the strain withinthe end effector during the crimping stroke for each clip from the firstclip cartridge. The surgical device further comprises a motor controllercomprising a memory configured to store the strains measured during thecrimping stroke for each clip from the first clip cartridge. The motorcontroller further comprises a processor in signal communication withthe memory and the strain gauge. The processor is configured to modifythe crimping stroke for each clip from the second clip cartridge basedon the strains stored in the memory.

Example 10

The surgical device of Example 9, wherein the housing comprises ahandle.

Example 11

The surgical device of Example 9, wherein the housing is couplable to arobotic system.

Example 12

A surgical device for applying clips comprising a shaft extending from ahousing, and an end effector extending from the shaft. The end effectorcomprises a first jaw comprising a first protrusion extending therefrom,and a second jaw comprising a second protrusion extending therefrom. Thefirst jaw and the second jaw are movable relative to each other betweenan open position and a closed position. The first jaw and the second jawat least partially define a receiving chamber. The surgical devicefurther comprises a cartridge comprising a storage chamber and aplurality of clips removably positioned within the storage chamber,wherein each clip is in a storage configuration. The surgical devicefurther comprises a firing drive configured to advance a clip positionedin the storage chamber onto the first protrusion and the secondprotrusion. The surgical device further comprises a crimping driveconfigured to move the first jaw and the second jaw to the open positionduring a retraction stroke. The clip positioned on the first protrusionand the second protrusion is transitioned from the storage configurationto a deployment configuration during the retraction stroke. Thedeployment configuration is larger than the storage configuration.

Example 13

The surgical device of Example 12, wherein the firing drive is furtherconfigured to advance the clip in the deployment configuration into thereceiving chamber, wherein the crimping drive is further configured tomove the first jaw and the second jaw to the closed position during acrimping stroke, and wherein the clip is crimped around the tissue of apatient during the crimping stroke.

Example 14

The surgical device of Example 13, wherein the crimped clip is releasedfrom the receiving chamber when the first jaw and the second jaw aremoved to the open position during another retraction stroke of thecrimping drive, and wherein another clip is transitioned from thestorage configuration to the deployment configuration during the anotherretraction stroke.

Example 15

The surgical device of Examples 12, 13, or 14, wherein the firing drivecomprises a support portion configured to support a proximal portion ofa clip during the transition of the clip from the storage configurationto the deployment configuration.

Example 16

The surgical device of Examples 12, 13, 14, or 15, wherein the first jawcomprises a first cam member, wherein the second jaw comprises a secondcam member, and wherein the first cam member and the second cam memberinteract with the crimping drive to move the first jaw and the secondjaw to the open position during the retraction stroke.

Example 17

The surgical device of Examples 12, 13, 14, 15, or 16, wherein the firstprotrusion comprises a first angled surface, wherein the secondprotrusion comprises a second angled surface, and wherein the firstangled surface and the second angled surface allow a clip to slide pastthe first protrusion and the second protrusion as the clip is advancedtowards the receiving chamber.

Example 18

The surgical device of Examples 12, 13, 14, 15, 16, or 17, wherein thecartridge is releasably attachable to the surgical device.

Example 19

A surgical device for applying clips comprising a shaft extending from ahousing and an end effector extending from the shaft. The end effectorcomprises a receiving chamber. The surgical device further comprises aplurality of clips removably positioned within a clip cartridge. Theclip cartridge is releasably attachable to the surgical device. Eachclip is configured to assume a plurality of states during the operationof the surgical device. The plurality of states comprises a storagestate, wherein each clip comprises a first size when in the storagestate. The plurality of states further comprises a deployment state,wherein each the clip comprises a second size larger than the first sizewhen in the deployment state. The surgical device further comprisespre-form features configured to transition a clip from the storage stateto the deployment state. The surgical device further comprises a firingdrive configured to advance a clip from the clip cartridge into thereceiving chamber of the end effector.

Example 20

The surgical device of Example 19, further comprising a crimping driveconfigured to crimp a clip in the receiving chamber around the tissue ofa patient during a crimping stroke.

Example 21

The surgical device of Example 20, wherein the crimped clip is releasedfrom the receiving chamber during a retraction stroke of the crimpingdrive, and wherein another clip is transitioned from the storage stateto the deployment state during the retraction stroke.

Example 22

The surgical device of Examples 19, 20, or 21, wherein the firing drivecomprises a support portion configured to support a proximal portion ofa clip during the transition of the clip from the storage state to thedeployment state.

Example 23

The surgical device of Example 22, wherein the support portion isfurther configured to support the proximal portion of the clip when theclip is advanced into the receiving chamber.

Example 24

The surgical device of Examples 19, 20, 21, 22, or 23, wherein the endeffector further comprises a first jaw and a second jaw which at leastpartially define the receiving chamber, wherein the first jaw and thesecond jaw are movable relative to each other between an open positionand a closed position, and wherein the pre-form features comprise afirst protrusion on the first jaw and a second protrusion on the secondjaw.

Example 25

The surgical device of Example 24, wherein the first protrusioncomprises a first angled surface and the second protrusion comprises asecond angled surface, and wherein the first angled surface and thesecond angled surface facilitate travel of a clip over the pre-formfeatures as the clip is moved towards the receiving chamber.

Example 26

A surgical device for applying clips comprising a shaft extending from ahousing and an end effector extending from the shaft. The end effectorcomprises a receiving chamber. The surgical device further comprises aplurality of clips removably positioned within the surgical device. Eachclip comprises a storage configuration and a deployment configurationduring the operation of the surgical device. The deploymentconfiguration is larger than the storage configuration. The surgicaldevice further comprises a reciprocating firing drive configured toadvance a first clip in the deployment configuration into the receivingchamber. The surgical device further comprises a crimping drive movablebetween a fully retracted position and a fully advanced position. Thecrimping drive is configured to crimp the first clip in the deploymentconfiguration when the crimping drive is moved toward the fully advancedposition. The first clip is released from the receiving chamber and asecond clip is transitioned to the deployment configuration when thecrimping drive is moved toward the fully retracted position.

Example 27

The surgical device of Example 26, further comprising a clip magazinereleasably attachable to the surgical device, wherein the clip magazinestores the plurality of clips in the storage configuration.

Example 28

The surgical device of Example 27, wherein the reciprocating firingdrive is further configured to advance a clip from the clip magazineinto a deployment position, wherein the clip is transitioned to thedeployment configuration in the deployment position.

Example 29

The surgical device of Example 28, wherein the end effector furthercomprises pre-form features configured to transition the clip from thestorage configuration to the deployment configuration when the crimpingdrive is moved toward the fully retracted position.

Example 30

The surgical device of Examples 26, 27, 28, or 29, wherein thereciprocating firing drive comprises a support portion configured tosupport a proximal portion of a first clip during the transition of thefirst clip from the storage configuration to the deploymentconfiguration.

Example 31

The surgical device of Example 30, wherein the support portion isfurther configured to support the proximal portion of the first clipduring the advancement of the first clip into the receiving chamber.

Example 32

A surgical device for clipping tissue comprising a shaft comprising alongitudinal axis. The surgical device further comprises a magazinehousing extending from the shaft, an end effector extending from themagazine housing, and a reloadable clip magazine releasably attachableto the magazine housing. The reloadable clip magazine is rotatable aboutthe longitudinal axis. The reloadable clip magazine comprises aplurality of clips removably positioned within the clip magazine, anotch, and a biasing member configured to protrude into the notch whenthe plurality of clips have been ejected from the reloadable clipmagazine into the end effector and the reloadable clip magazine has beendetached from the magazine housing. The biasing member prevents thereloadable clip magazine from being re-attached to the magazine housingwhen the reloadable clip magazine is empty.

Example 33

The surgical device of Example 32, wherein the biasing member is movedout of engagement with the notch when at least one clip is loaded intothe clip magazine.

Example 34

The surgical device of Examples 32 or 33, wherein the magazine housingcomprises a protrusion configured to extend into the notch when the clipmagazine is not empty and is attached to the magazine housing.

Example 35

The surgical device of Examples 32, 33, or 34, further comprising afiring member configured to eject the clips from the clip magazine intothe end effector when the clip magazine is attached to the magazinehousing.

Example 36

The surgical device of Example 35, wherein the end effector comprises afirst jaw and a second jaw, wherein one of the first jaw and the secondjaw is movable relative to the other of the first jaw and the second jawbetween an open position and a closed position, and wherein the firstjaw and the second jaw are configured to crimp a clip positioned in theend effector when the first jaw and the second jaw are moved toward theclosed position.

Example 37

The surgical device of Examples 32, 33, 34, 35, or 36, furthercomprising an articulation joint rotatably connecting the magazinehousing to the shaft, wherein the magazine housing is movable relativeto the shaft between an un-articulated position and an articulatedposition.

Example 38

A surgical device for clipping tissue comprising a shaft extending froma housing and a magazine housing extending from the shaft. The magazinehousing comprises a lockout release. The surgical device furthercomprises an end effector extending from the magazine housing and areloadable clip magazine releasably attachable to the magazine housing.The reloadable clip magazine comprises a plurality of clips removablypositioned within the clip magazine and a lockout configured to preventthe plurality of clips from being ejected from the clip magazine whenthe clip magazine is not attached to the magazine housing, wherein, whenthe clip magazine is attached to the magazine housing, the lockout ofthe clip magazine is defeated by the lockout release of the magazinehousing to allow the clips to be ejected from the clip magazine.

Example 39

The surgical device of Example 38, wherein the clips are ejected fromthe clip magazine by a firing member after the lockout is defeated.

Example 40

The surgical device of Examples 38 or 39, wherein the magazine housingfurther comprises a bottom portion and a top portion movable relative tothe bottom portion between an open position and a closed position. Thelockout release extends from the top portion.

Example 41

The surgical device of Example 40, wherein the lockout release isdefeated by the lockout when the clip magazine is attached to themagazine housing and the top portion of the magazine housing is in theclosed position.

Example 42

The surgical device of Examples 40 or 41, wherein the lockout release ofthe magazine housing comprises a protrusion extending from the topportion of the magazine housing.

Example 43

The surgical device of Example 42, wherein the lockout of the clipmagazine comprises a biasing member.

Example 44

The surgical device of Example 43, wherein the protrusion of the topportion of the magazine housing engages the biasing member of the clipmagazine to defeat the lockout of the clip magazine when the clipmagazine is attached to the magazine housing and the top portion of themagazine housing is in the closed position.

Example 45

The surgical device of Examples 38, 39, 40, 41, 42, 43, or 44, furthercomprising an articulation joint rotatably connecting the magazinehousing to the shaft, wherein the magazine housing is movable relativeto the shaft between an un-articulated position and an articulatedposition.

Example 46

A surgical device for clipping tissue comprising a shaft extending froma housing, an end effector extending from the shaft, and a replaceableclip magazine operably attachable to the end effector. The end effectorcomprises a receiver. The replaceable clip magazine comprises aplurality of clips removably positioned therein, and a biasing memberconfigured to prevent the plurality of clips from being ejected form theclip magazine when the clip magazine is not attached to the endeffector.

Example 47

The surgical device of Example 46, wherein the clip magazine furthercomprises a notch, and wherein the biasing member extends into the notchwhen the clip magazine is empty.

Example 48

The surgical device of Example 47, wherein the end effector furthercomprises a protrusion configured to extend into the notch when the clipmagazine is attached to the end effector, wherein the protrusionprevents the biasing member from extending into the notch.

Example 49

The surgical device of Examples 46, 47, or 48, further comprising afiring member configured to eject the clips from the clip magazine intothe receiver of the end effector when the clip magazine is attached tothe end effector.

Example 50

The surgical device of Example 49, wherein the end effector comprises afirst jaw and a second jaw that at least partially define the receiver,wherein one of the first jaw and the second jaw is movable relative tothe other of the first jaw and the second jaw between an open positionand a closed position, and wherein the first jaw and the second jaw areconfigured to crimp a clip positioned in the receiver when the first jawand the second jaw are moved toward the closed position.

Example 51

The surgical device of Examples 46, 47, 48, 49, or 50, furthercomprising an articulation joint rotatably connecting the end effectorto the shaft, wherein the end effector is movable relative to the shaftbetween an un-articulated position and an articulated position.

Example 52

A surgical device for clipping tissue comprising a housing comprising amotor configured to output rotary motions. The surgical device furthercomprises a shaft extending from the housing, and an end effectorextending from the shaft. The end effector comprises a first jawrotatably coupled to the shaft, a second jaw rotatably coupled to theshaft, and a receiving chamber. The surgical device further comprises acrimping drive configured to move the first jaw and the second jawtoward each other during a crimping stroke. The crimping drive isoperably responsive to the rotary motions. The surgical device furthercomprises a clip magazine comprising a plurality of clips. The pluralityof clips are in a storage configuration when in the clip magazine. Thesurgical device further comprises a reciprocating firing driveconfigured to move a clip from the clip magazine to a forming positionin the end effector during a clip feed stroke in response to the rotarymotions, wherein a clip in the forming position is in a formingconfiguration, and wherein the forming configuration is the same as thestorage configuration. The surgical device further comprises a motorcontroller configured to control the reciprocating firing driveindependent of the crimping drive. The motor controller is configured toactuate the motor to perform the clip feed stroke after the surgicaldevice has been inserted into a treatment area.

Example 53

The surgical device of Example 52, further comprising a processor and amemory, wherein the motor controller is configured to control the motorvia the processor and the memory.

Example 54

The surgical device of Example 53, wherein the processor is configuredto execute a motor control algorithm stored in the memory to move thecrimping drive through the crimping stroke independent of the clip feedstroke.

Example 55

The surgical device of Example 53, wherein the processor is configuredto execute a motor control algorithm stored in the memory to advance thereciprocating firing drive through the clip feed stroke independent ofthe crimping stroke.

Example 56

The surgical device of Examples 52, 53, 54, or 55, wherein the clipmagazine is replaceable.

Example 57

A surgical device for clipping tissue comprising a shaft extending froma housing, and an end effector extending from the shaft. The endeffector comprises a first jaw, a second jaw, and a crimping drive. Thefirst jaw and the second jaw are movable relative to each other betweenan open configuration and a closed configuration. The crimping drive isconfigured to transition the first jaw and the second jaw between theopen configuration and the closed configuration. The surgical devicefurther comprises a clip magazine comprising a plurality of clips, afeeder drive configured to move a clip from the clip magazine to aforming position in the end effector, and a control system configured tooperate the surgical device in a plurality of modes. The plurality ofmodes comprises a first mode wherein the first jaw and the second jaware moved toward the open configuration and the feeder drive does notmove a clip from the clip magazine into the forming position, and asecond mode wherein the first jaw and the second jaw are moved towardthe open configuration and the feeder drive moves a clip from themagazine into the forming position.

Example 58

The surgical device of Example 57, further comprising a motor configuredto output rotary motions, wherein the crimping drive is operablyresponsive to the rotary motions, and wherein the feeder drive isoperably responsive to the rotary motions.

Example 59

The surgical device of Examples 57 or 58, wherein the crimping drive andthe feeder drive are operably independent to one another.

Example 60

The surgical device of Examples 57, 58, or 59, wherein the controlsystem comprises a motor controller comprising a processor and a memory,wherein the motor controller is configured to control the motor based oninstructions stored in the memory and executed by the processor.

Example 61

The surgical device of Example 60, wherein the processor is configuredto execute a motor control algorithm stored in the memory to transitionthe first jaw and the second jaw towards the open configuration.

Example 62

The surgical device of Example 60, wherein the processor is configuredto execute a motor control algorithm stored in the memory to move a theclip from the clip magazine to the forming position in the end effector.

Example 63

The surgical device of Examples 57, 58, 59, 60, 61, or 62, wherein theclip magazine is replaceable.

Example 64

The surgical device of Examples 57, 58, 59, 60, 61, 62, or 63, whereinthe clip magazine is reloadable with another plurality of clips.

Example 65

A surgical device for clipping tissue comprising a housing comprising amotor configured to output rotary motions, a shaft extending from thehousing, and an end effector extending from the shaft. The end effectorcomprises a first jaw rotatably coupled to the shaft, and a second jawrotatably coupled to the shaft. The surgical device further comprises acrimping drive configured to move the first jaw and the second jawtoward each other during a crimping stroke in response to the rotarymotions. The surgical device further comprises a clip cartridgecomprising a plurality of clips. The surgical device further comprises afiring member configured to move a clip from the clip cartridge into theend effector during a clip feed stroke in response to the rotarymotions. The surgical device further comprises a motor controllerconfigured to control the firing member independent of the crimpingdrive. The motor controller is configured to actuate the motor toperform the clip feed stroke after the surgical device has been insertedinto a treatment area.

Example 66

The surgical device of Example 65, further comprising a processor and amemory, wherein the motor controller is configured to control the motorvia the processor and the memory.

Example 67

The surgical device of Examples 65 or 66, wherein the crimping drive andthe firing member are operably independent to one another.

Example 68

The surgical device of Example 66, wherein the motor controller isconfigured to execute a motor control algorithm stored in the memory tomove the first jaw and the second jaw toward each other during thecrimping stroke independent of the clip feed stroke.

Example 69

The surgical device of Example 66, wherein the motor controller isfurther configured to execute a motor control algorithm stored in thememory to advance the firing member through the clip feed strokeindependent of the crimping stroke.

Example 70

The surgical device of Examples 65, 66, 67, 68, or 69, wherein the clipcartridge is replaceable with another clip cartridge comprising anotherplurality of clips.

Example 71

The surgical device of Examples 65, 66, 67, 68, 69, or 70, wherein theclip cartridge is reloadable with another plurality of clips.

Example 72

A surgical device for clipping tissue comprising a housing comprising amotor configured to output rotary motions, a power source configured tosupply power to the motor, a current meter configured to measure thecurrent draw of the motor, a shaft extending from the housing, and anend effector extending from the shaft. The end effector comprises afirst jaw rotatably coupled to the shaft, a second jaw rotatably coupledto the shaft, and a receiver. The surgical device further comprises acrimping drive configured to move the first jaw and the second jawtowards each other during a crimping stroke. The crimping drive isoperably responsive to the rotary motions. The surgical device furthercomprises a clip magazine comprising a plurality of clips, and areciprocating firing drive configured to advance a clip from the clipmagazine into the receiver of the end effector during a firing stroke.The reciprocating firing drive is operably responsive to the rotarymotions. The surgical device further comprises a motor controllerconnected to the current meter. The motor controller is configured toadjust the speed of the firing stroke when the current draw of the motorreaches a threshold value.

Example 73

The surgical device of Example 72, wherein after the speed of the firingstroke is adjusted and the current draw of the motor still exceeds thethreshold value, the motor controller is configured to stop the motor.

Example 74

The surgical device of Example 72, wherein after the speed of the firingstroke is adjusted and the current draw of the motor still exceeds thethreshold value, the motor controller is configured to reverse thedirection of the motor to retract the firing member through a shortstroke distance.

Example 75

The surgical device of Example 74, wherein the crimping drive is furtherconfigured to move the first jaw and the second jaw away from each otherduring a retraction stroke.

Example 76

The surgical device of Example 75, wherein after the firing member isretracted through the short stroke distance the motor controller isfurther configured to move the crimping drive through the retractionstroke.

Example 77

The surgical device of Examples 72, 73, 74, 75, or 76, wherein the clipmagazine is removably attachable to the surgical device.

Example 78

The surgical device of Examples 72, 73, 74, 75, 76, or 77, wherein theclip magazine is configured to be reloaded with another plurality ofclips when the clip magazine has been spent.

Example 79

A surgical device for clipping tissue comprising a housing comprising amotor configured to output rotary motions, a power source configured tosupply power to the motor, a motor controller configured to control themotor, a current meter configured to measure the current draw of themotor, a shaft extending from the housing, and an end effector extendingfrom the shaft. The end effector comprises a first jaw and a second jaw.The first jaw and the second jaw are movable between a fully openposition, an open position, and a closed position relative to eachother. The surgical device further comprises a crimping drive configuredto move the first jaw and the second jaw relative to each other betweenthe fully open position, the open position, and the closed position. Thesurgical device further comprises a clip magazine comprising a pluralityof clips. The surgical device further comprises a reciprocating firingdrive configured to advance a clip from the clip magazine into the endeffector during a firing stroke. The reciprocating firing drive isoperably responsive to the rotary motions, wherein when a clip is jammedin the end effector the current meter is configured to detect the jammedclip and the crimping drive is configured to move the first jaw and thesecond jaw to the fully open position.

Example 80

The surgical device of Example 79, wherein the crimping drive isoperably responsive to the rotary motions.

Example 81

The surgical device of Examples 79 or 80, wherein the motor controlleris in signal communication with the motor and the current meter.

Example 82

The surgical device of Examples 79, 80, or 81, wherein the current meteris configured to measuring the current draw of the motor, and whereinthe current meter detects the jammed clip when the current draw of themotor exceeds a threshold value.

Example 83

The surgical device of Examples 79, 80, 81, or 82, wherein the first jawand the second jaw comprise protrusions, and wherein the protrusions areoperably engaged by the crimping drive to move the first jaw and thesecond jaw to the fully open position when the current meter detects thejammed clip.

Example 84

The surgical device of Examples 79, 80, 81, 82, or 83, wherein the motorcontroller is configured to retract the reciprocating firing drive ashort stroke distance when the current meter detects the jammed clip.

Example 85

The surgical device of Examples 79, 80, 81, 82, 83, or 84, wherein theclip magazine is removably attachable to the surgical device.

Example 86

The surgical device of Examples 79, 80, 81, 82, 83, 84, or 85, whereinthe clip magazine is configured to be reloaded with another plurality ofclips when the clip magazine has been spent.

Example 87

A surgical device for clipping tissue comprising a housing comprising amotor. The surgical device further comprises a shaft extending from thehousing, a current sensor configured to measure the current draw of themotor, and an end effector extending from the shaft. The end effectorcomprises a first jaw and a second jaw. The first jaw and the second jaware movable relative to each other between an open position and a closedposition. The surgical device further comprises a clip cartridgeconfigured to store a plurality of clips. The surgical device furthercomprises a feeder member configured to advance a clip from the clipcartridge during a firing stroke. The feeder member is furtherconfigured to retract during a retraction stroke. The feeder member isoperably responsive to the rotary motions. The surgical device furthercomprises a closure tube configured to move the first jaw and the secondjaw toward the open position during a retraction stroke. The closuretube is operably responsive to the rotary motions. The surgical devicefurther comprises a motor controller in signal communication with thecurrent sensor and the motor. The motor controller is configured to movethe feeder member through the retraction stroke and move the closuretube through the retraction stroke when the current sensor detects acurrent draw that exceeds a threshold value.

Example 88

The surgical device of Example 87, wherein the threshold value isindicative of a clip which has been jammed in the end effector.

Example 89

The surgical device of Examples 87 or 88, wherein the first jaw and thesecond jaw comprise protrusions, and wherein the protrusions areoperably engaged by the closure tube during the retraction stroke of theclosure tube.

Example 90

The surgical device of Examples 87, 88, or 89, wherein the clipcartridge is removably attachable to the surgical device.

Example 91

The surgical device of Examples 87, 88, 89, or 90, wherein the clipcartridge is configured to be reloaded with another plurality of clipswhen the clip cartridge has been spent.

Example 92

A surgical device for clipping tissue comprising a housing. The housingcomprising a motor configured to output rotary motions. The surgicaldevice further comprises a shaft extending from the housing and an endeffector extending from the shaft. The end effector comprises a firstjaw rotatably coupled to the shaft, a second jaw rotatably coupled tothe shaft, and a receiver. The surgical device further comprises a clipmagazine comprising a plurality of clips. The surgical device furthercomprises a reciprocating firing drive operably responsive to the rotarymotions. The firing drive is configured to move a clip from the clipmagazine into the receiver. The surgical device further comprises acrimping drive operably responsive to the rotary motions. The crimpingdrive is configured to move the first jaw and the second jaw towardseach other during a crimping stroke, wherein a clip positioned in thereceiver is crimped during the crimping stroke. The surgical devicefurther comprises a strain gauge positioned in at least one of the firstjaw and the second jaw. The strain gauge is configured to measure thestrain within the end effector during the crimping stroke. The surgicaldevice further comprises a motor controller in communication with themotor and the strain gauge, wherein the motor controller is configuredto adjust the output torque of the motor based on the measured strain inthe strain gauge during the crimping stroke.

Example 93

The surgical device of Example 92, wherein the strain gauge comprises aproximal strain gauge, and where the surgical device further comprises adistal strain gauge positioned in at least one of the first jaw and thesecond jaw.

Example 94

The surgical device of Example 93, wherein the proximal strain gauge isconfigured to measure a first strain in the end effector during thecrimping stroke, and wherein the distal strain gauge is configured tomeasure a second strain in the end effector during the crimping stroke.

Example 95

The surgical device of Example 94, wherein the motor controller isconfigured to adjust the output torque of the motor based on thedifference between the first strain and the second strain during thecrimping stroke.

Example 96

The surgical device of Examples 92, 93, 94, or 95, wherein the clipmagazine is removable attachable to the surgical device.

Example 97

A surgical device for clipping tissue comprising a housing. The housingcomprising a motor configured to output rotary motions. The surgicaldevice further comprises a shaft extending from the housing and an endeffector extending from the shaft. The end effector comprises a firstjaw and a second jaw. The first jaw and the second jaw are movablerelative to each other between an open position and a closed position.The surgical device further comprises a crimping drive configured tomove the first jaw and the second jaw to a closed position during acrimping stroke. The crimping drive is operably responsive to the rotarymotions. The surgical device further comprises a clip magazinecomprising a plurality of metal clips, a firing drive configured to movea metal clip from the clip magazine into the end effector, a firstresistive sensing circuit configured to detect the position of the metalclip in the end effector, and a second resistive sensing circuitconfigure to determine whether the first jaw and the second jaw are inthe open position or the closed position.

Example 98

The surgical device of Example 97, further comprising a power source,wherein the first resistive sensing circuit comprises the power source,the first jaw, a metal clip positioned in the end effector, the secondjaw, a resistor, and a current meter.

Example 99

The surgical device of Example 98, wherein the power source isconfigured to supply a current to the first resistive sensing circuit,wherein the current meter is configured to measure an output current ofthe first resistive sensing circuit.

Example 100

The surgical device of Example 99, wherein the output current measuredat the current meter is indicative of the position of the clip in theend effector.

Example 101

The surgical device of Example 97, further comprising a power source,wherein the second resistive sensing circuit comprises the power source,a first lead in the first jaw, a second lead in the second jaw, aresistor, and a current meter.

Example 102

The surgical device of Example 101, wherein the first lead is insulatedfrom the first jaw, and wherein the second lead is insulated form thesecond jaw.

Example 103

The surgical device of Examples 101 or 102, wherein the power source isconfigured to supply a current to the second resistive sensing circuit,and wherein the current meter is configured to measure an output currentof the second resistive sensing circuit.

Example 104

The surgical device of Example 103, wherein the output current measuredat the current meter is indicative of the position of the first jawrelative to the second jaw.

Example 105

The surgical device of Examples 97, 98, 99, 100, 101, 102, 103, or 104,wherein the clip magazine is removably attachable to the surgicaldevice.

Example 106

A surgical device for clipping tissue comprising a housing. The housingcomprises a motor configured to output rotary motions. The surgicaldevice further comprises a shaft extending from the housing and an endeffector extending from the shaft. The end effector comprises a firstjaw rotatably coupled to the shaft, a second jaw rotatably coupled tothe shaft, and a receiver. The surgical device further comprises acrimping drive configured to move the first jaw and the second jawtowards each other during a crimping stroke. The crimping drive isoperably responsive to the rotary motions. The surgical device furthercomprises a clip magazine comprising a plurality of clips. Each clip isstored in the clip magazine in a stored configuration. The surgicaldevice further comprises a reciprocating firing drive configured to movea clip from the magazine to a forming position in the end effectorduring a clip feed stroke. The clip in the forming position is in aforming configuration that is the same as the stored configuration. Thesurgical device further comprises a resistive sensing circuit configuredto detect when a clip is in the forming position. The crimping drive isfurther configured to expand the clip in the forming configuration to adeployable configuration that is larger than the forming configurationafter the resistive sensing circuit detects the clip in the formingposition.

Example 107

The surgical device of Example 106, wherein the resistive sensingcircuit comprises a power supply configured to supply a voltage to theend effector, a current meter, and a resistor, and wherein the currentmeter is configured to measure the current at the resistor.

Example 108

The surgical device of Example 107, wherein the current measured at theresistor is indicative of the position of a clip in the end effector.

Example 109

The surgical device of Examples 107 or 108, wherein when a clip is inthe forming position the current measured by the current meter is afirst current, wherein when a clip is in the deployable configurationthe current measured by the current meter is a second current, andwherein the second current is smaller than the first current.

Example 110

The surgical device of Examples 106, 107, 108, or 109, wherein the clipmagazine is removably attachable to the surgical device.

Example 111

The surgical device of Examples 106, 107, 108, 109, or 110, wherein theclip magazine is configured to be reloaded with another plurality ofclips when the plurality of clips have been spent.

The devices, systems, and methods disclosed in the Subject Applicationcan be used with the devices, systems, and methods disclosed in U.S.Provisional Patent Application Ser. No. 62/659,900, entitled METHOD OFHUB COMMUNICATION, filed Apr. 19, 2018; U.S. Provisional PatentApplication Ser. No. 62/611,341, entitled INTERACTIVE SURGICAL PLATFORM,filed Dec. 28, 2017; U.S. Provisional Patent Application Ser. No.62/611,340, entitled CLOUD-BASED MEDICAL ANALYTICS, filed Dec. 28, 2017;and U.S. Provisional Patent Application Ser. No. 62/611,339, entitledROBOT ASSISTED SURGICAL PLATFORM, filed Dec. 28, 2017.

The devices, systems, and methods disclosed in the Subject applicationcan also be used with the devices, systems, and methods disclosed inU.S. patent application Ser. No. 15/908,021, entitled SURGICALINSTRUMENT WITH REMOTE RELEASE, filed Feb. 28, 2018; U.S. patentapplication Ser. No. 15/908,012, entitled SURGICAL INSTRUMENT HAVINGDUAL ROTATABLE MEMBERS TO EFFECT DIFFERENT TYPES OF END EFFECTORMOVEMENT, filed Feb. 28, 2018; U.S. patent application Ser. No.15/908,040, entitled SURGICAL INSTRUMENT WITH ROTARY DRIVE SELECTIVELYACTUATING MULTIPLE END EFFECTOR FUNCTIONS, filed Feb. 28, 2018; U.S.patent application Ser. No. 15/908,057, entitled SURGICAL INSTRUMENTWITH ROTARY DRIVE SELECTIVELY ACTUATING MULTIPLE END EFFECTOR FUNCTIONS,filed Feb. 28, 2018; U.S. patent application Ser. No. 15/908,058,entitled SURGICAL INSTRUMENT WITH MODULAR POWER SOURCES, filed Feb. 28,2018; and U.S. patent application Ser. No. 15/908,143, entitled SURGICALINSTRUMENT WITH SENSOR AND/OR CONTROL SYSTEMS, filed Feb. 28, 2018.

The surgical instrument systems described herein can be used inconnection with the deployment and deformation of staples. Variousembodiments are envisioned which deploy fasteners other than staples,such as clamps or tacks, for example. Moreover, various embodiments areenvisioned which utilize any suitable means for sealing tissue. Forinstance, an end effector in accordance with various embodiments cancomprise electrodes configured to heat and seal the tissue. Also, forinstance, an end effector in accordance with certain embodiments canapply vibrational energy to seal the tissue. In addition, variousembodiments are envisioned which utilize a suitable cutting means to cutthe tissue.

The entire disclosures of:

U.S. Pat. No. 8,075,571, entitled SURGICAL CLIP APPLIER METHODS, whichissued on Dec. 13, 2011;

U.S. Pat. No. 8,038,686, entitled CLIP APPLIER CONFIGURED TO PREVENTCLIP FALLOUT, which issued on Oct. 18, 2011;

U.S. Pat. No. 7,699,860, entitled SURGICAL CLIP, which issued on Apr.20, 2010;

U.S. patent application Ser. No. 11/013,924, entitled TROCAR SEALASSEMBLY, now U.S. Pat. No. 7,371,227;

U.S. patent application Ser. No. 11/162,991, entitled ELECTROACTIVEPOLYMER-BASED ARTICULATION MECHANISM FOR GRASPER, now U.S. Pat. No.7,862,579;

U.S. patent application Ser. No. 12/364,256, entitled SURGICALDISSECTOR, now U.S. Patent Application Publication No. 2010/0198248;

U.S. patent application Ser. No. 13/536,386, entitled EMPTY CLIPCARTRIDGE LOCKOUT, now U.S. Pat. No. 9,282,974;

U.S. patent application Ser. No. 13/832,786, entitled CIRCULAR NEEDLEAPPLIER WITH OFFSET NEEDLE AND CARRIER TRACKS, now U.S. Pat. No.9,398,905;

U.S. patent application Ser. No. 12/592,174, entitled APPARATUS ANDMETHOD FOR MINIMALLY INVASIVE SUTURING, now U.S. Pat. No. 8,123,764;

U.S. patent application Ser. No. 12/482,049, entitled ENDOSCOPICSTITCHING DEVICES, now U.S. Pat. No. 8,628,545;

U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLINGINSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat.No. 9,072,535;

U.S. patent application Ser. No. 11/343,803, entitled SURGICALINSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No. 7,845,537;

U.S. patent application Ser. No. 14/200,111, entitled CONTROL SYSTEMSFOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629;

U.S. patent application Ser. No. 14/248,590, entitled MOTOR DRIVENSURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now U.S. Pat. No.9,826,976;

U.S. patent application Ser. No. 14/813,242, entitled SURGICALINSTRUMENT COMPRISING SYSTEMS FOR ASSURING THE PROPER SEQUENTIALOPERATION OF THE SURGICAL INSTRUMENT, now U.S. Patent ApplicationPublication No. 2017/0027571;

U.S. patent application Ser. No. 14/248,587, entitled POWERED SURGICALSTAPLER, now U.S. Pat. No. 9,867,612;

U.S. patent application Ser. No. 12/945,748, entitled SURGICAL TOOL WITHA TWO DEGREE OF FREEDOM WRIST, now U.S. Pat. No. 8,852,174;

U.S. patent application Ser. No. 13/297,158, entitled METHOD FORPASSIVELY DECOUPLING TORQUE APPLIED BY A REMOTE ACTUATOR INTO ANINDEPENDENTLY ROTATING MEMBER, now U.S. Pat. No. 9,095,362;

International Application No. PCT/US2015/023636, entitled SURGICALINSTRUMENT WITH SHIFTABLE TRANSMISSION, now International PatentPublication No. WO 2015/153642 A1;

International Application No. PCT/US2015/051837, entitled HANDHELDELECTROMECHANICAL SURGICAL SYSTEM, now International Patent PublicationNo. WO 2016/057225 A1;

U.S. patent application Ser. No. 14/657,876, entitled SURGICAL GENERATORFOR ULTRASONIC AND ELECTROSURGICAL DEVICES, U.S. Patent ApplicationPublication No. 2015/0182277;

U.S. patent application Ser. No. 15/382,515, entitled MODULAR BATTERYPOWERED HANDHELD SURGICAL INSTRUMENT AND METHODS THEREFOR, U.S. PatentApplication Publication No. 2017/0202605;

U.S. patent application Ser. No. 14/683,358, entitled SURGICAL GENERATORSYSTEMS AND RELATED METHODS, U.S. Patent Application Publication No.2016/0296271;

U.S. patent application Ser. No. 14/149,294, entitled HARVESTING ENERGYFROM A SURGICAL GENERATOR, U.S. Pat. No. 9,795,436;

U.S. patent application Ser. No. 15/265,293, entitled TECHNIQUES FORCIRCUIT TOPOLOGIES FOR COMBINED GENERATOR, U.S. Patent ApplicationPublication No. 2017/0086910; and

U.S. patent application Ser. No. 15/265,279, entitled TECHNIQUES FOROPERATING GENERATOR FOR DIGITALLY GENERATING ELECTRICAL SIGNAL WAVEFORMSAND SURGICAL INSTRUMENTS, U.S. Patent Application Publication No.2017/0086914, are hereby incorporated by reference herein.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, a device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the stepsincluding, but not limited to, the disassembly of the device, followedby cleaning or replacement of particular pieces of the device, andsubsequent reassembly of the device. In particular, a reconditioningfacility and/or surgical team can disassemble a device and, aftercleaning and/or replacing particular parts of the device, the device canbe reassembled for subsequent use. Those skilled in the art willappreciate that reconditioning of a device can utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

The devices disclosed herein may be processed before surgery. First, anew or used instrument may be obtained and, when necessary, cleaned. Theinstrument may then be sterilized. In one sterilization technique, theinstrument is placed in a closed and sealed container, such as a plasticor TYVEK bag. The container and instrument may then be placed in a fieldof radiation that can penetrate the container, such as gamma radiation,x-rays, and/or high-energy electrons. The radiation may kill bacteria onthe instrument and in the container. The sterilized instrument may thenbe stored in the sterile container. The sealed container may keep theinstrument sterile until it is opened in a medical facility. A devicemay also be sterilized using any other technique known in the art,including but not limited to beta radiation, gamma radiation, ethyleneoxide, plasma peroxide, and/or steam.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdo not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

What is claimed is:
 1. A surgical device for applying clips, comprising:a shaft extending from a housing; an end effector extending from saidshaft, comprising: a first jaw comprising a first protrusion extendingtherefrom; and a second jaw comprising a second protrusion extendingtherefrom, wherein said first jaw and said second jaw are movablerelative to each other between an open position and a closed position,and wherein said first jaw and said second jaw at least partially definea receiving chamber; a cartridge, comprising: a storage chamber; and aplurality of clips removably positioned within said storage chamber,wherein each clip of said plurality of clips is in a storageconfiguration; a firing drive configured to advance a clip of saidplurality of clips positioned in said storage chamber onto said firstprotrusion and said second protrusion; and a crimping drive configuredto move said first jaw and said second jaw to said open position duringa retraction stroke, wherein said clip positioned on said firstprotrusion and said second protrusion is transitioned from said storageconfiguration to a deployment configuration during said retractionstroke, wherein said deployment configuration is larger than saidstorage configuration, and wherein each clip of said plurality of clipsis transitioned from said storage configuration to said deploymentconfiguration prior to being advanced by said firing drive into saidreceiving chamber.
 2. The surgical device of claim 1, wherein saidfiring drive is further configured to advance said clip in saiddeployment configuration into said receiving chamber, wherein saidcrimping drive is further configured to move said first jaw and saidsecond jaw to said closed position during a crimping stroke, and whereinsaid clip is configured to be crimped around patient tissue during saidcrimping stroke.
 3. The surgical device of claim 2, wherein said crimpedclip is released from said receiving chamber when said first jaw andsaid second jaw are moved to said open position during anotherretraction stroke of said crimping drive, and wherein another clip istransitioned from said storage configuration to said deploymentconfiguration during said another retraction stroke.
 4. The surgicaldevice of claim 2, wherein said firing drive comprises a support portionconfigured to support a proximal portion of said clip during thetransition of said clip from said storage configuration to saiddeployment configuration.
 5. The surgical device of claim 1, whereinsaid first jaw comprises a first cam member, wherein said second jawcomprises a second cam member, and wherein said first cam member andsaid second cam member interact with said crimping drive to move saidfirst jaw and said second jaw to said open position during saidretraction stroke.
 6. The surgical device of claim 1, wherein saidcartridge is releasably attachable to the surgical device.
 7. A surgicaldevice for applying clips, comprising: a shaft extending from a housing;an end effector extending from said shaft, comprising: a first jawcomprising a first protrusion extending therefrom; and a second jawcomprising a second protrusion extending therefrom, wherein said firstjaw and said second jaw are movable relative to each other between anopen position and a closed position, and wherein said first jaw and saidsecond jaw at least partially define a receiving chamber; a cartridge,comprising: a storage chamber; and a plurality of clips removablypositioned within said storage chamber, wherein each clip of saidplurality of clips is in a storage configuration; a firing driveconfigured to advance a clip of said plurality of clips positioned insaid storage chamber onto said first protrusion and said secondprotrusion; and a crimping drive configured to move said first jaw andsaid second jaw to said open position during a retraction stroke,wherein said clip positioned on said first protrusion and said secondprotrusion is transitioned from said storage configuration to adeployment configuration during said retraction stroke, wherein saiddeployment configuration is larger than said storage configuration,wherein said first protrusion comprises a first angled surface, whereinsaid second protrusion comprises a second angled surface, and whereinsaid first angled surface and said second angled surface allow said clipto slide past said first protrusion and said second protrusion as saidclip is advanced towards said receiving chamber.
 8. A surgical devicefor applying clips, comprising: a shaft extending from a housing; an endeffector extending from said shaft, wherein said end effector comprisesa receiving chamber; a plurality of clips removably positioned within aclip cartridge, wherein said clip cartridge is releasably attachable tosaid surgical device, wherein each clip of said plurality of clips isconfigured to assume a plurality of states during operation of saidsurgical device, and wherein said plurality of states comprises: astorage state, wherein each clip of said plurality of clips comprises afirst size when in said storage state; and a deployment state, whereineach clip of said plurality of clips comprises a second size larger thansaid first size when in said deployment state; pre-form featuresconfigured to transition a clip of said plurality of clips from saidstorage state to said deployment state; and a firing drive configured toadvance said clip from said clip cartridge into said receiving chamberof said end effector, wherein each clip of said plurality of clips istransitioned from said storage state to said deployment state prior tobeing advanced by said firing drive into said receiving chamber.
 9. Thesurgical device of claim 8, further comprising a crimping driveconfigured to crimp said clip in said receiving chamber around patienttissue during a crimping stroke.
 10. The surgical device of claim 9,wherein said crimped clip is released from said receiving chamber duringa retraction stroke of said crimping drive, and wherein another clip istransitioned from said storage state to said deployment state duringsaid retraction stroke.
 11. The surgical device of claim 8, wherein saidfiring drive comprises a support portion configured to support aproximal portion of said clip during the transition of said clip fromsaid storage state to said deployment state.
 12. The surgical device ofclaim 11, wherein said support portion is further configured to supportsaid proximal portion of said clip when said clip is advanced into saidreceiving chamber.
 13. The surgical device of claim 8, wherein said endeffector further comprises a first jaw and a second jaw which at leastpartially define said receiving chamber, wherein said first jaw and saidsecond jaw are movable relative to each other between an open positionand a closed position, and wherein said pre-form features comprise afirst protrusion on said first jaw and a second protrusion on saidsecond jaw.
 14. A surgical device for applying clips, comprising: ashaft extending from a housing; an end effector extending from saidshaft, wherein said end effector comprises a receiving chamber; aplurality of clips removably positioned within a clip cartridge, whereinsaid clip cartridge is releasably attachable to said surgical device,wherein each clip of said plurality of clips is configured to assume aplurality of states during operation of said surgical device, andwherein said plurality of states comprises: a storage state, whereineach clip of said plurality of clips comprises a first size when in saidstorage state; and a deployment state, wherein each clip of saidplurality of clips comprises a second size larger than said first sizewhen in said deployment state; pre-form features configured totransition a clip of said plurality of clips from said storage state tosaid deployment state; and a firing drive configured to advance saidclip from said clip cartridge into said receiving chamber of said endeffector, wherein said end effector further comprises a first jaw and asecond jaw which at least partially define said receiving chamber,wherein said first jaw and said second jaw are movable relative to eachother between an open position and a closed position, wherein saidpre-form features comprise a first protrusion on said first jaw and asecond protrusion on said second jaw, wherein said first protrusioncomprises a first angled surface and said second protrusion comprises asecond angled surface, and wherein said first angled surface and saidsecond angled surface facilitate travel of said clip over said pre-formfeatures as said clip is moved towards said receiving chamber.
 15. Asurgical device for applying clips, comprising: a shaft extending from ahousing; an end effector extending from said shaft, wherein said endeffector comprises a receiving chamber; a plurality of clips removablypositioned within said surgical device, wherein each clip of saidplurality of clips comprises a storage configuration and a deploymentconfiguration during operation of the surgical device, wherein saiddeployment configuration is larger than said storage configuration; areciprocating firing drive configured to advance a first clip of saidplurality of clips in said deployment configuration into said receivingchamber; and a crimping drive movable between a fully retracted positionand a fully advanced position, wherein said crimping drive is configuredto crimp said first clip in said deployment configuration when saidcrimping drive is moved toward said fully advanced position, and whereinsaid first clip is released from said receiving chamber and a secondclip of said plurality of clips is transitioned to said deploymentconfiguration when said crimping drive is moved toward said fullyretracted position.
 16. The surgical device of claim 15, furthercomprising a clip magazine releasably attachable to the surgical device,wherein said clip magazine stores said plurality of clips in saidstorage configuration.
 17. The surgical device of claim 16, wherein saidreciprocating firing drive is further configured to advance a clip ofsaid plurality of clips from said clip magazine into a deploymentposition, wherein said clip is transitioned to said deploymentconfiguration in said deployment position.
 18. The surgical device ofclaim 17, wherein said end effector further comprises pre-form featuresconfigured to transition said clip from said storage configuration tosaid deployment configuration when said crimping drive is moved towardsaid fully retracted position.
 19. The surgical device of claim 15,wherein said reciprocating firing drive comprises a support portionconfigured to support a proximal portion of said first clip during thetransition of said first clip from said storage configuration to saiddeployment configuration.
 20. The surgical device of claim 19, whereinsaid support portion is further configured to support the proximalportion of said first clip during the advancement of said first clipinto said receiving chamber.